Harvesting of bone from the iliac crest--comparison of the anterior and posterior sites

In 1998 we harvested a total of 127 bone grafts from the iliac crest of 65 male and 53 female patients aged 8-80 years. We measured the quantity of bone obtained, the operating time and the donor site morbidity of the anterior approach (n=81) compared with the posterior approach (n=46). The mean volume of bone harvested was 15 cm(3) (range: 9-25.5) of monocorticocancellous- or bicortico-cancellous bone chips or those from a trephine bur. The mean operating time for the anterior approach was 35 min (range: 22-48), for the posterior approach 40 min (range: 32-55). There were 15 complications, which were limited to those in whom the volume of bone exceeded 17 cm(3). The posterior approach caused less morbidity, notably in the form of significantly less pain and irregularity of gait. The patient has, however, to be repositioned during operation, which added to its total duration.