The use of autograft bone is the best option when undertaking a procedure that requires bone graft because it is osteogenic, osteoconductive and osseo-inductive. Pain, morbidity and complications associated with harvesting iliac or non-iliac sites occur in between 6% and 30% of cases.
An alternative source of graft with possibly a lower morbidity is the intramedullary canal.
In this study, 28 patients undergoing 30 arthrodesis procedures on the hindfoot had a mean of 48 cm(3) (43 to 50) of bone harvested locally from the hindfoot or the tibial shaft by antegrade or retrograde reaming.
No patient sustained a fracture of the calcaneum, talus or tibia.
There was no morbidity except for one complication when the reamer breached the medial tibial cortex.
This healed uneventfully.
This method of using the reamer-irrigator-aspirator system is an extension of the standard technique of intramedullary reaming of the lower limb: it produces good-quality bone graft with viable growth factors consistent with that of the iliac crest, and donor site morbidity is low.
This is an efficient method of obtaining autologous bone for use in arthrodesis of the ankle or hindfoot.
2012-01-05
Eng.
The Journal of bone and joint surgery. British volume
Florida Orthopaedic Institute, Foot and Ankle Service, 13020 Telecom Parkway, Temple Terrace, Florida 33637, USA. fixbones [at] aol.com
J Bone Joint Surg Br. 2012 Jan;94(1):75-9
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