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Lower extremity autograft site causes persistent pain 1 year after harvest
Autologous bone graft harvest of the foot, ankle and tibia resulted in persistent pain up to 1 year after the procedure, especially in the lower-extremity graft harvest sites.
“Autologous bone graft harvest in the foot, ankle and tibia may result in acute pain in excess of the operative fusion procedure as well as 1 year of pain that may persist a year following surgery in some patients,” the authors wrote in their study.
In the prospective, randomized, multicenter clinical trial, researchers analyzed pain levels of 24 patients who underwent harvest at the distal tibia, 17 at the iliac bone crest, 69 at the proximal tibia and 20 at the calcaneus. Patients were followed up to 1 year after surgery.
The overall average Visual Analog Scale (VAS) pain score was 32.9 points immediately following bone graft harvest, which decreased to 6.1 points at 1 year. Immediately after surgery, 35.8% of patients had significant pain compared to 8.5% of patients at 1 year. Although most patients’ pain decreased over time, 17 patients were pain free at 1 year and patients harvested at locations in the lower extremity had persistent pain at 1 year. The researchers reported patients who had grafts harvested at the calcaneus had the most significant and prolonged pain at 1 year.
“A careful discussion concerning the need for autologous bone graft along with the risks of this procedure should be undertaken with the patient prior to surgery to perform adequate informed consent,” the researchers wrote in the study.
Disclosures: The authors received statistical support from Biomimetic Therapeutics Inc.