A review of morbidity associated with bone harvest from the proximal tibial metaphysis

Aim: The proximal tibia has become a well-accepted donor site for autologous bone, but there are few reports of complications with its use in maxillofacial reconstruction. Our retrospective study quantifies incidence and type of complications related to the proximal tibia bone harvest. Patients and method: Sixty-three surgeries performed from March 2000 to March 2004 were reviewed; 23 male and 38 female patients underwent unilateral proximal tibia metaphysis harvest. No additives were used to increase the volume of the grafts. All patients were allowed to ambulate as tolerated on the 2nd postoperative day. Results: All patients developed ecchymosis and edema on the donor limb, which resolved quickly. All patients reported minor gait disturbances. Complications were seen in 12 patients (19%) and included prolonged pain at the donor site and prolonged gait disturbances well beyond 2 weeks, seroma formation, paresthesia around the skin incision, bleeding, scar formation after wound breakdown, and knee joint perforation. Conclusion: Harvesting bone from the proximal tibial metaphysis is a safe procedure associated with a low incidence of overall complications. However, prolonged pain and gait disturbances are to be expected in 10% of the patients.