The proximal tibia metaphysis: a reliable donor site for bone grafting?

Low complication rates have been reported when cancellous bone is taken from the proximal tibia. The current study was done to determine the volume of cancellous bone that can be harvested from the proximal tibia and to determine the risk for postoperative tibia plateau fracture. The average compressed volume that could be harvested from nine tibiae was 5.4 cc compared with a reported volume of 6.0 cc from the iliac crest. In eight cadavers, the proximal tibia was decancellated in eight tibias. The decancellated and the matching eight contralateral intact tibias were loaded to determine the force required to cause a tibial plateau fracture. The null hypothesis, that there is no difference between the decancellated and the intact tibias, could not be rejected. The current experimental study supports the clinical findings that a sufficient amount of cancellous bone can be harvested from the proximal tibial metaphysis and that the risk of postoperative fracture is not increased. Therefore, the proximal tibia is a reliable cancellous bone graft donor site for clinical practice.