Comparison of Donor-Site Engraftment After Harvesting Vascularized and Nonvascularized Iliac Bone Grafts

Ghassemi, Alireza; Ghassemi, Mehrangiz; Riediger, Dieter; Hilgers, Ralf-Dieter; Gerressen, Marcus

doi:10.1016/j.joms.2009.04.013

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 8 , Pages 1589-1594, August 2009

Comparison of Donor-Site Engraftment After Harvesting Vascularized and Nonvascularized Iliac Bone Grafts

Alireza Ghassemi, MD, DMD, PhD
- Assistant Professor, Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University, Aachen, Germany
- Address correspondence and reprint requests to Dr Dr Ghassemi: Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
Mehrangiz Ghassemi, DMD
- Fellow, Department of Orthodontics, University Hospital of the Aachen University, Aachen, Germany
Dieter Riediger, MD, DMD, PhD
- Professor and Chair, Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University, Aachen, Germany
Ralf-Dieter Hilgers, DSc, PhD
- Professor and Chair, Institute of Medical Statistics, University Hospital of the Aachen University, Aachen, Germany
Marcus Gerressen, MD, DMD, PhD
- Assistant Professor, Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of the Aachen University, Aachen, Germany

Purpose

The objective of this study is to characterize the donor-site morbidity after harvesting of nonvascularized and vascularized iliac bone grafts.

Patients and Methods

Clinical data of 353 patients were collected for analysis. In addition, a questionnaire was sent to all patients asking about their perceptions of different parameters. In an individual age-matched layout, we compared 34 patients with nonvascularized iliac bone grafts with 34 patients with vascularized iliac bone grafts.

Results

Transplantation of vascularized bone grafts has been increasingly performed at our institution. The mean age was 41.5 years in the nonvascularized group and 48.6 years in the vascularized group. The main reason for the bony defect in the vascularized group was malignancy. The majority of postoperative functional problems were observed in obese patients. No patient had serious or long-term complications at the donor site. The amount of bone graft taken affected postoperative sensitivity disturbance and caused postoperative functional problems and pain.

Conclusions

We conclude that the iliac crest is a suitable site for harvesting both vascularized and nonvascularized bone grafts measuring up to 10 × 3 cm. For larger defects that require a larger bone graft, a vascularized bone graft is more suitable with a better predictable healing capability. No significant differences in donor-site morbidity were found between the vascularized and nonvascularized bone grafts if a similar amount of bone was taken for transplant.