• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.257-262
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• 2013

Objectives: Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. Materials and Methods: An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Results: Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Conclusion: Patients who undergo tibial grafts must be careful of excessive external force after the operation.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.407-412
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• 2018

Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.540-543
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• 2000

The purpose of this retrospective study was to evaluate the treatment outcome of proximal tibial graft. Thirty-nine patients were grafted with proximal tibia for the repair of maxillofacial defect. Complications can be considered incidental and neglectable clinical significance. It is concluded that the proximal tibial metaphysis offers a promising alternative sources of cancellous bone for the repair of maxillofacial defect.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.97-101
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• 1999

Purpose : The purpose of this study is to prevent thc graft-tunnel mismatch by measuring the patellar tendon length, intertunnel distance, tibial tunnel length and by obtaining appropriate bone block length. Materials and Methods : Authors analyzed 15 patients who had taken the anterior cruciate ligament reconstruction from March 1997 to June 1999. Tibial guide was always set on the "endo" $40^{\circ}$ position(Acufex, MA, USA). We measured the following indices, intertunnel distance(X), tibial tunnel length(T), patellar tendon length(N), tibia bone plug length(Y). Both of the femoral tunnel length(F) and the patellar bone plug length(P) were made in 25mm. The appropriate tibial bone plug length was simply calculated by subtracting the patellar tendon length from the sum of the intertunnel distance and thc tibial tunnel length(Y=X+T-N). Results : The average indices were as follows ; the intertunnel distance(X) was $23.4{\pm}1.4mm$, the tibial tunnel length(T) was $43.6{\pm}1.7mm$, the patellar tendon length was $40{\pm}2.4mm$, and the tibia bone plug length was $27{\pm}2.4mm$. Conclusion : In authors' endoscopic technique, establishment of individually determined optimal tibial bone plug length, based on total tunnel length and patellar tendon length could prevent the problem of graft-tunnel mismatch.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.241-248
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• 2008

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

• The Journal of the Korean dental association
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• v.11 no.3
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• pp.195-198
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• 1973

The authors have treated a squamous-cell carcinoma occurred in molar region of the right mandible in 52-year old woman by means of bony resection and banked tibial bone graft, and made the normal appearance of her face. The result as follow: 1) The healing of a graft is similar to the healing of an uninfected fracture except that it will take considerably longer. It is of the utmost importance that it should be well immobilized, otherwsie there is danger of absorption of bone and fibrous union. 2) Until the graft acquires a blood supply it is easily infected, for it has no defence against organisms, so it is most important to prevent wound infection set in.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.97-98
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• 2007

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.114-118
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• 1998

We retrospectively evaluated the changes in the diameter of the tibial tunnel over time following the reconstruction of the anterior cruciate ligament with a bone-patella tendon-bone(BPTB) autograft(25 cases) and quadruple semitendinosus(ST) graft(27 cases) in 52 patients at one year postoperatively. The changes in the geometry of the bony tunnel were measured with radiography. The demensions at final follow up were correated with the clinical results. An increased width of the tibial tunnel was noted in all cases. On the femoral side, however, no tunnel expansion was noted. In AP view, the average tibial tunnel enlargement in ST and BPTB graft groups were 1.30mm(13%) and 1.82mm(17%), respectively. In lateral view, the average tibial tunnel enlargement in ST and BPTB graft group was 1.30mm(13%) and 2.04mm(19%). The differences between two groups were not statistically significant, however, there was evidence of a borderline significance(P=0.0502). Although the tunnel enlargement does not appear to adversely affect the clinical outcome in the short term, the exact mechanism which are involved should be demonstrated. Furthermore histologic study is needed to evaluate graft replacements with emphasis on the graft-tunnel interface.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.228-231
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• 1998

This is a clinical and retrospective study of 36 patients received the autogenous particulated cancellous bone grafts from anterior iliac and proximal tibial metaphysis and we compared the clinical postoperative complications in operation sites and donor site morbidity. The results of this study indicate that, in all our patients, the proximal tibia provided an adquate volume of cancellous bone and there were no special contraindications, in choosing and using the proximal tibia as a donor site in most oral and maxillofacial cancellous bone graft surgeries. Furthermore, the proximal tibial metaphysis would appear a more easily obtainable cancellous bone source and offer a superior clinical results than anterior iliac crest in donor site morbidity.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2012.10a
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• pp.881-882
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• 2012