title: Maximum Quantity of Bone Available for Harvest From the Anterior Iliac Crest, Posterior Iliac Crest, and Proximal Tibia Using a Standardized Surgical Approach: A Cadaveric Study.
abstract: OBJECTIVE
  The 3 most common sites for obtaining autogenous bone grafts are the anterior iliac crest (AIC), posterior iliac crest (PIC), and proximal tibia (PT). The purpose of this study was to determine the maximum amount of corticocancellous bone that could be harvested from the AIC, PIC and PT when using a standardized surgical approach.
  
  
  METHODS
  The maximum volume of cortical and cancellous bone from the AIC, PIC, and PT was harvested from 44 cadavers using approaches from a review of the literature. Uncompressed and compressed corticocancellous bone volumes were measured by water volume displacement. Bivariate analyses of bone volumes, gender, and medical comorbidities were performed using the exact Wilcoxon rank-sum test. A general linear model using ranks was used to assess the effect of gender, medical comorbidity, and site separately for total uncompressed and compressed bone measurements.
  
  
  RESULTS
  Forty-two AIC corticocancellous grafts provided an uncompressed total average of 26.29 mL and a compressed total average of 20.58 mL. Thirty-three PIC grafts yielded a total average of 33.82 mL of uncompressed bone and 24.11 mL of compressed. Thirty-eight PT samples provided a total average of 18.11 mL of uncompressed bone and 9.03 mL of compressed bone. No statistically relevant correlations were found between compressed bone volumes and body mass index or age. No statistically relevant association was found between bone quantity and medical comorbidity for any of the graft sites. The average rank of bone volume per site after controlling for gender and medical comorbidity showed that the PIC yielded the most and the PT yielded the least compressed and uncompressed bone amounts (P < .001).
  
  
  CONCLUSIONS
  Results indicate that the PIC has a larger maximum amount of corticocancellous bone than the AIC and PT with a standardized approach. The maximum volumes of attainable bone from the AIC, PIC, and PT were lower than commonly cited in the literature.
authors.affiliation: Fourth-Year Resident, Department of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Thomas.burk@phhs.org.
authors.forename: Thomas
authors.initials: T
authors.lastname: Burk
authors.affiliation: Fourth-Year Resident, Department of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Jorge
authors.initials: J
authors.lastname: Del Valle
authors.affiliation: Director, Section of Oral and Maxillofacial Surgery, Dallas Veteran's Affairs Medical Center, Dallas; Faculty, Department of Cell Biology and Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Finn
authors.affiliation: Professor, Department of Orthodontics, University of North Carolina, Chapel Hill, NC.
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007085:Ilium / Q000033:anatomy & histology / Q000637:transplantation*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000033:anatomy & histology / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014182:Transplantation, Autologous