This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ahlmann, E.
Right arrow Articles by Holtom, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ahlmann, E.
Right arrow Articles by Holtom, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?
The Journal of Bone and Joint Surgery (American) 84:716-720 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Comparison of Anterior and Posterior Iliac Crest Bone Grafts in Terms of Harvest-Site Morbidity and Functional Outcomes

Elke Ahlmann, MD, Michael Patzakis, MD, Nikolaos Roidis, MD, MSc, Lane Shepherd, MD and Paul Holtom, MD

Investigation performed at the Department of Orthopaedics, Keck School of Medicine, University of Southern California, USC University Hospital, Los Angeles, California

Elke Ahlmann, MD
Michael Patzakis, MD
Nikolaos Roidis, MD, MSc
Lane Shepherd, MD
Paul Holtom, MD
Department of Orthopaedics, Keck School of Medicine, University of Southern California, USC University Hospital, 1510 San Pablo Street, Suite 322, Los Angeles, CA 90033-4608. E-mail address for M.J. Patzakis: orthopod{at}hsc.usc.edu E-mail address for N. Roidis: roidis@in.gr

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background : Previous studies have demonstrated high complication rates after harvest of iliac crest bone grafts. This study was undertaken to compare the morbidity related to the harvest of anterior iliac crest bone graft with that related to the harvest of posterior iliac crest bone graft and to determine differences in functional outcome.

Methods : The medical records of eighty-eight consecutive patients who had undergone a total of 108 iliac crest bone-grafting procedures for the treatment of chronic osteomyelitis from 1991 to 1998 were retrospectively reviewed. Demographic characteristics, the location of the harvest, the volume of bone graft that was harvested, the estimated blood loss, and postoperative complications were recorded. Fifty-eight patients completed a questionnaire pertaining to postoperative and residual pain, sensory disturbances, functional limitations, cosmetic appearance, and overall satisfaction with the bone-graft harvesting procedure.

Results : Sixty-six anterior and forty-two posterior bone-graft harvest sites were evaluated at a minimum of two years after the operation. A major complication was associated with 8% (five) of the sixty-six anterior sites and 2% (one) of the forty-two posterior sites. The rates of minor complications were 15% (ten) and 0%, respectively. In the series as a whole, there were ten minor complications (9%) and six major complications (6%). The rates of both minor complications (p = 0.006) and all complications (p = 0.004) were significantly higher after the anterior harvest procedures than they were after the posterior procedures. The postoperative pain at the donor site was significantly more severe (p = 0.0016) and of significantly greater duration (p = 0.0017) after the anterior harvests. No patient reported functional limitations at the latest follow-up evaluation.

Conclusions: In this series, the complication rate was lower than those previously reported by other investigators. Harvest of a posterior iliac crest bone graft was associated with a significantly lower risk of postoperative complications. On the basis of the results of this study, we recommend that iliac crest bone graft be harvested posteriorly whenever possible.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
J. A. Rihn, C. Gates, S. D. Glassman, F. M. Phillips, J. D. Schwender, and T. J. Albert
The Use of Bone Morphogenetic Protein in Lumbar Spine Surgery
J. Bone Joint Surg. Am., September 1, 2008; 90(9): 2014 - 2025.
[Full Text] [PDF]

Home page
 JBJSHome page
B. Peterson, P. G. Whang, R. Iglesias, J. C. Wang, and J. R. Lieberman
Osteoinductivity of Commercially Available Demineralized Bone Matrix. Preparations in a Spine Fusion Model
J. Bone Joint Surg. Am., October 1, 2004; 86(10): 2243 - 2250.
[Abstract] [Full Text] [PDF]