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General Orthopaedics

Reconstruction of Iliac Crest donor site with hydroxyapatite bioactive glass ceramic composite (Chitra-HABG) - a prospective study

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Introduction

Significant donor site morbidity (3–61%) has been associated with tri-cortical iliac crest bone graft harvesting and reconstruction of the defect has been shown to reduce it. Chitra-HABG (Chitra-Hydroxyapatite-Bio-active glass ceramic composite) is an indigenously developed ceramic which has been evaluated as a bone graft substitute.

Aim

To prospectively validate the hypothesis that iliac crest donor site morbidity is a structural issue and reconstructing the crest reduces its incidence. The study also evaluates the efficacy of Chitra - HABG as a material for reconstructing the crest.

Methods

26 cases of iliac crest reconstruction with Chitra-HABG blocks were prospectively evaluated. Outcome measures were donor site morbidity as assessed clinically and radiological assessment for ceramic incorporation, dissolution, fragmentation and migration.

Results

At the end of one year from surgery, 25 patients (96.15%) had no donor site pain. Radiological evaluation showed that ceramic incorporation was complete in 21 cases, partial in three and absent in two. Partial dissolution of ceramic was noticed in three patients and migration in one.

Conclusion

The present study validates our hypothesis that the donor site morbidity following tri-cortical iliac crest graft harvesting is probably a structural issue and it can be reduced by reconstruction of the defect. It also highlights the fact that the Chitra-HABG block is an excellent material for reconstruction of the iliac crest defect, as it gets incorporated into the surrounding bone without adverse effects.

Significance

Study describes a simple and effective method to decrease iliac crest donor site morbidity.

Level of evidence: IV

Study Design

Prospective study.

Summary

Prospectively evaluate the efficacy of Chitra-HABG blocks for iliac crest reconstruction.