Reconstruction of iliac crest with bovine cancellous allograft after bone graft harvest for symphysis pubis arthrodesis.
OBJECTIVE
The aim of this study was to evaluate the safety and efficiency, as well as the incorporation characteristics of a specific type of xenograft used for iliac crest defects post-harvesting tri-cortical iliac crest bone graft.


METHODS
Sixteen patients diagnosed with chronic anterior pelvic pain were operated for pubic symphysis fusion. The tri-cortical graft harvested from the iliac crest was inserted into the pubic symphysis and compressed with a reconstruction plate. The defect in the iliac crest was filled with a block of cancellous bovine substitute (Tutobone®). The length of iliac crest defect, time to fusion of pubic symphysis, time to incorporation of the graft and complications were recorded. The postoperative pain and patients' satisfaction were evaluated.


RESULTS
The median age of patients was 36.5 years (range 27-75). Fusion was obtained in 15 patients (94 %). The median time to fusion was four months (range three to seven). The length of the iliac crest bone defect ranged from 40 to 70 mm. Integration of the bovine substitute was achieved in 15 patients (94 %) over a median period of three months (range two to six). The postoperative median pain score was 2 (range 1-5). Twelve patients (75 %) reported good satisfaction. No major complications or allergic reactions were observed.


CONCLUSIONS
The xenograft used in this study provided a safe and effective method of reconstruction of iliac crest donor site defects. It has satisfactory incorporation, high biocompatibility and no signs of inflammatory reactions. This new technique is simple and easily reproducible in routine clinical practice.
Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds General Infirmary, Clarendon Wing Level A, Great George Street, LS1 3EX, Leeds, West Yorkshire, UK.
Konstantinos G
KG
Makridis
Mudussar Abrar
MA
Ahmad
Nikolaos K
NK
Kanakaris
Evangelos M
EM
Fragkakis
Peter V
PV
Giannoudis
D000328:Adult; D000368:Aged; D000818:Animals; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002417:Cattle; D005260:Female; D006801:Humans; D007085:Ilium / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000000981:diagnostic imaging; D017060:Patient Satisfaction; D011631:Pubic Symphysis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D014183:Transplantation, Heterologous / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome