Minimally invasive tibial bone harvesting under intravenous sedation

Collecting high amounts of autogenous bone often results in considerable donor site morbidity. The hypothesis evaluated with this prospective study is that a modified approach for tibial bone harvesting using a minimally invasive access under local anesthesia plus sedation in an office setting compares favorably in terms of amount of bone harvested, morbidity, and patient satisfaction with more aggressive approaches previously reported.

Thirty-eight patients (18 women, 10 men) were treated using this method and followed prospectively. A medial approach to the proximal tibia was performed in all cases. A 10 mm incision gives access to an 8 mm manual trephine, which creates a bony window. Cancellous bone is released from the proximal compartment and a bone filter connected to suction allows fast removal of bone particles. Amount of bone harvested (compressed and non-compressed), surgical time, and complications were recorded.

Mean surgical time was 14 minutes (range, 9 to 20 minutes). Volume of compressed cancellous bone ranged between 18 and 30 cc (mean, 28 cc).

Tibial bone harvesting through a medial minimally invasive approach with a bone filter yields satisfactory results in terms of bone volume, surgical time, and patient satisfaction.