A randomized controlled trial comparing the pain and morbidity of harvesting bone graft from the inner and outer cortex of the anterior iliac crest

Abstract

Objectives : This study compared the donor site pain scores between the inner and outer cortex anterior iliac crest bone graft harvesting Design : A randomized controlled trial Setting : King Chulalongkorn Memorial Hospital, Bangkok Participants : 61 patients, inpatient who required iliac bone graft harvesting Methodology : A consecutive series of 61 patients ; whose anterior iliac bone graft was randomized harvesting from either inner or outer cortex. The patients were evaluated and asked for the donor site pain measured by visual analog scale and were followed up for pain and other donor site morbidity for 90 days. The pain scores of both groups at 7, 30 and 90 days post operatively were then statistically compared by repeated measure ANOVA. Results : There was no difference in age, sex and wound size between both groups. The median of pain scores of 30 patients with inner cortex anterior iliac bone graft harvesting were 40 at day 7, 12 at day 30, 5 day 90. The pain scores of 31 patients with outer cortex anterior iliac bone graft harvesting were 10 at day 7, 5 at day 30, 0 at day 90. By using the repeated measure ANOVA; it revealed that the pain scores of the outer cortex group were lower than those of the inner cortex group with statistically significant (P < 0.001). One case of the lateral cutaneous nerve of thigh was detected in the inner cortex group. Conclusions : It’s indicated that harvesting anterior iliac bone graft from outer cortex caused less pain than inner cortex.