A modified technique of harvesting tibial cancellous bone and its use for sinus grafting

Abstract

Autogenous bone is the gold standard graft for sinus augmentation. The harvest of autogenous bone grafts from intraoral sites does often not provide sufficient bone volume and quality. A modified technique of harvesting a tibial cancellous graft is presented. With a micro-bone saw, a bony lid is prepared at the medial condyle of the tibia. The lid stays attached to the tendinous pes anserinus. Following the harvest, the lid is repositioned accurately. This method offers some distinct advantages. A sufficient amount of biologically highly valuable cancellous bone may be harvested for sinus grafting and possibly other surgeries with bone augmentation. The procedure may be performed under local anaesthesia and does not require hospitalisation. Neither major complications nor serious postoperative morbidity were observed.

Proximal tibial bone graft: the volume of cancellous bone, and strength of decancellated tibias by the medial approach

“…This means that the larger the bone volume harvested the more risk of fracture occurring in the tibia plateau. Therefore, the patient should be refrained from playing sport or jumping for at least 2-3 months postoperatively 2,7,11,14 . This study showed that there was a strong correlation between non-compressed and compressed cancellous bone volume, so double thumb compression is a reliable method for measuring the compressed cancellous bone volume.…”

“…CATONE et al 3 reported the use of the proximal tibial metaphysis as cancellous bone graft in orthognathic surgery, the alveolar cleft, preprosthetic surgery and major jaw reconstruction. Several studies reported a complication rate of 1-4% 3,7,11,12,14,16,20,22 from harvesting proximal tibia, which is less than the iliac bone harvesting rate. Proximal tibia harvesting also requires less operating time, is easy to perform 16 and has less gait disturbance when compared to iliac bone harvesting 10 .…”

A novel approach revealing the effect of a collagenous membrane on osteoconduction in maxillary sinus floor elevation with β-tricalcium phosphate

“…For bone reconstruction in the oral and maxillofacial region autologous bone is still the "gold standard" as grafting material. These bone grafts can be harvested from the iliac crest (Sindet-Pedersen and Enemark, 1990;Thorwarth et al, 2005), calvarium (Iturriaga and Ruiz, 2004), tibia (Jakse et al, 2001), rib (Borstlap et al, 1990) or intraoral donor sites such as the maxillary tuberosity, the retromolar area of the mandible (Thorwarth et al, 2005;Becktor et al, 2008) or chin (Borstlap et al, 1990). Autologous bone grafts have excellent osteoinductive, osteoconductive, and osteogenic properties (Oppenheimer et al, 2008).…”

Obliteración del seno frontal mediante injerto de tibia y plasma rico en plaquetas para el tratamiento de la osteomielitis crónica

“…El injerto del hueso proximal de tibia es un procedimiento relativamente simple de realizar, con una baja tasa de complicaciones 10 . Se pueden obtener entre 5 y 30 cc de hueso esponjoso en partículas, tomados con cucharillas o trefinas de la meseta tibial.…”