Research Article
Volume 12 Issue 5 - 2021
A Retrospective Review of 611 Proximal Tibial Bone Graft Harvests
J Joseph Anderson1*, Loren K Spencer2, Brooke Lynn Anderson3, Devin S Bland4, Anthony M Chesser5, Daniel R Wright6, Riley J Rampton7 and G Parker Peresko8
1Surgeon, New Mexico Bone and Joint Institute, Director and American Foundation of Lower Extremity Surgery and Research, Las Cruces, NM, USA
2Surgeon, New Mexico Bone and Joint Institute, Alamogordo, NM, USA
3BS, Research Fellow, AFLESR/Medical Student, Midwestern University, Glendale, AZ, USA
4Surgeon, Private Practice, Scottsdale, AZ, USA
5Surgeon, ORA Orthopedics, Moline, IL, USA
6Surgeon, Logan Medical Center, Logan, WV, USA
7Fellow, American Foundation of Lower Extremity Surgery and Research, Las Cruces, NM, USA
8Resident Postgraduate Year 3, Swedish Medical Center, Seattle, WA, USA
*Corresponding Author: J Joseph Anderson, Surgeon, New Mexico Bone and Joint Institute, Director and American Foundation of Lower Extremity Surgery and Research, Las Cruces, NM, USA.
Received: March 08, 2021; Published: April 28, 2021


In this study, which is the largest to date, we evaluated 611 patients from 2005 to 2017 who underwent a proximal medial tibia bone graft harvest. The purpose of this study was to evaluate the amount of autogenous bone graft collected from the proximal tibia and the postoperative complications that were incurred at the aforementioned site. Patient evaluation extended to a total of 24 months. Serial radiographs were used to evaluate healing at the proximal tibia harvest site and at the receiving site of the grafted bone. The average amount of autogenous graft taken from the proximal medial tibia bone graft harvest site was 12.8 ± 6.6cc, with a range of 5cc to 40cc of autograft material dependent upon necessity for primary surgery. No major complications were observed at the donor site. There were 36 instances of complications that occurred from the 611 bone grafts obtained (5.89%). The most common complication was hematoma and superficial dehiscence, both of which occurred in 12 patients (1.96%, respectively). Use of a 10-point visual analog scale was implemented, which showed an average of 1.4 out of 10 pain during the first week post-operatively. This reduced to 0.04 out of 10 at 24 months post-op.

The harvesting procedure, which is not technically challenging, can be executed effectively and relatively quickly in the OR, in a time averaging just over 19 minutes. There was a complication rate of 5.89% (36 of 611 surgeries). Complications included 12 cases of hematoma, 12 cases of superficial dehiscence, 6 cases of neuritis, and 3 cases of superficial cellulitis. Four fractures occurred away from the harvest site due to patient falls, which all healed uneventfully following appropriate immobilization. Statistical analysis was performed on the portion of the population with complications (36/611). There was no statistical significance with the amount of graft taken and complications. There was a correlation with younger age (age range) and higher rates of complications. There was no correlation found between age and time to heal. There was a correlation between larger amounts of graft (greater than 6cc) and longer time to heal. Our hypothesis was that proximal tibia bone grafting would not have higher rates of complications when compared to the average rate of complications in patients utilizing allograft in similar primary surgeries, reported by other authors [4,9,10,11-21].

The proximal aspect of the tibia is a safe and reliable source for harvesting bone graft material, having no significant correlation to postoperative complications in comparison to postoperative complications of patients undergoing similar primary surgeries utilizing allograft rather than proximal tibia autograft (5.89% vs 5 - 14.9% [9,13,14,17]), as well as providing adequate amounts of autologous graft material (≥ 5cc and up to 40cc) for a variety of primary surgical procedures. We conclude that the proximal tibia is a safe and reliable source of autologous bone graft material and can be efficiently collected utilizing the provided harvesting technique and placement.


Keywords: Proximal Tibia; Bone Graft; Autogenous; Autologous; Allograft


  1. J Joseph Anderson., et al. “A Retrospective Review of 522 Distal Tibial Bone Graft Harvests”. EC Orthopaedics9 (2018): 717-727.
  2. Blitch El and Ricotta PJ. “Introduction to bone grafting”. The Journal of Foot and Ankle Surgery 35 (1996): 458.
  3. Burchardt H. “Biology of bone grafting”. Orthopedic Clinics of North America 18 (1987): 187.
  4. Klokkevold PR and Jovanovic SA. “Advanced Implant Surgery and Bone Grafting Techniques”. In Newman, MG; Takei, HM; Carranza, FA. Carranza's Clinical Periodontology (9th edition). Philadelphia: W.B. Saunders (2002): 907-908.
  5. Friedlaender GE. “Current concepts review bone grafts”. Journal of Bone and Joint Surgery American 69 (1987): 786.
  6. Arrington ED., et al. “Complications of Iliac Crest Bone Graft Harvesting”. Clinical Orthopaedics 329 (1996): 300-309.
  7. McCormack HM., et al. “Clinical applications of visual analogue scales: a critical review”. Psychological Medicine 18 (1988): 1007-1019.
  8. Raikin SM and Brislin K. “Local bone graft harvested from the distal tibia or calcaneus for surgery of the foot and ankle”. Foot and Ankle International: SAGE Journals 6 (2005): 449-453.
  9. Donley BG and Richardson EG. “Bone grafting in foot surgery”. Foot and Ankle International 4 (1996): 242.
  10. Brown CH. “A technique for distal tibial bone graft for arthrodesis of the foot and ankle”. Foot and Ankle International 9 (2000): 780-781.
  11. Boone DW. “Complications of iliac crest graft and bone grafting alternatives in foot and ankle surgery”. Foot and Ankle Clinics 1 (2003): 1-14.
  12. Silber JS., et al. “Donor Site Morbidity After Anterior Iliac Crest Bone Harvest for Single-Level Anterior Cervical Discectomy and fusion”. Spine 2 (2003): 134-139.
  13. Ahlmann E., et al. “Comparison of Anterior and Posterior Iliac Bone Grafts in Terms of Harvest-Site Morbidity and Functional Outcomes”. The Journal of Bone and Joint Surgery 84-A (2002): 5.
  14. Anderson J and Haji A. “Autologous Distal Tibia Bone Graft Harvest: Results in 77 Patients”. Podiatry Institute Update 14 (2007): 81-87.
  15. Mendicino RW., et al. “Techniques for harvesting autogenous bone graft of the lower extremity”. The Journal of Foot and Ankle Surgery 5 (1996): 428-435.
  16. Chou Loretta., et al. “Stress Fracture as a Complication of Autogenous Bone Graft Harvest from the Distal Tibia”. Foot and Ankle International 2 (2007): 199-201.
  17. Saltrick KR., et al. “Utilization of autogenous corticocancellous bone graft from the distal tibia for reconstructive surgery of the foot and ankle”. Journal of Foot and Ankle Surgery 5 (1996): 406-412.
  18. Torg JS., et al. “Fractures of the base of the fifth metatarsal distal to the tuberosity”. Journal of Bone and Joint Surgery 66A (1984): 209-215.
  19. Danziger MB., et al. “Distal tibia bone graft for arthrodesis of the foot and ankle”. Foot and Ankle International 4 (1995): 187-190.
  20. Banwart, JC., et al. “Iliac crest bone graft harvest donor site morbidity: a statistical evaluation”. Spine 20 (1995): 1055-1060.
  21. O'Keeffe RM Jr., et al. “Harvesting of autogenous cancellous bone graft from the proximal tibial metaphysis. A review of 230 cases”. Journal of Orthopaedic Trauma 4 (1991): 469-474.
  22. Geideman W., et al. “Clinical results of harvesting autogenous cancellous graft from the ipsilateral proximal tibia for use in foot and ankle surgery”. Foot and Ankle International 7 (2004): 451-455.
Citation: J Joseph Anderson., et al. “A Retrospective Review of 611 Proximal Tibial Bone Graft Harvests” EC Orthopaedics 12.5 (2021): 11-21.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.