Technical note: medial approach for proximal tibia bone graft using a manual trephine

ObjectiveThe purpose of this review is to assess the use of a manual trephine for harvesting bone grafts from the medial aspect of proximal tibia.Study designThe medial approach for proximal tibia is described with detailed landmarks and anatomic relationships, pointing out the advantages of using a manual trephine. A retrospective review of 33 patients who underwent this technique in a 3-year period is reported.ResultsThe medial aspect of proximal tibia was found to supply the requirements of cancellous bone graft for all the osseous defects, with the exception of bilateral sinus lifts. There were no major complications at the donor site; only 2 cases of local infection and unaesthetic scar were found, respectively. Morbidity at the receptor site was attributable to the lack of soft tissue coverage.ConclusionMedial approach for proximal tibia with a manual trephine seems to be a valuable tool to harvest autogenous cancellous bone grafts with simplicity, safety, and predictability.