What Is a Bone Graft?

A bone graft takes bone from one area of the body and puts it in another area to provide support and/or fill in areas where bone is missing. Bone grafts are either taken from the patient (autograft) or taken from a bone donor (allograft). The best bone graft provides enough bone and healing with minimal problems for the patient.

Proximal tibial bone graft is one of many sources of autograft. The proximal tibia is the upper portion of the leg or shin bone that is just below the knee joint. Getting bone from this body part usually is less painful than from other areas like the pelvis. Some other common sources of autograft used in foot and ankle surgery are the heel bone (calcaneus) or the bone just above the ankle (distal tibia).


Your foot and ankle orthopaedic surgeon may recommend bone grafting as part of certain procedures to improve the chances of your bones healing, but it is not always necessary. Bone grafting may be used on fractures that have not healed or fusion procedures (forcing two or more separate bones to grow together) involving the ankle, midfoot, big toe, or other foot/ankle joints.

The main reason to not have a bone graft is if you already have hardware in the upper leg. Such devices include knee replacements, plates, and screws and rods. Other reasons to avoid a bone graft include prior skin problems or infections.


The graft usually is taken from the same leg that is being operated on. Your surgeon will make an incision over an area of the upper leg. The incision may be small or large depending on how much graft is needed for your foot/ankle.

Tools such as drills, chisels, and scoops are used to collect the bone graft. At times, the surgeon may leave a drain in the leg at the bone for a short time to prevent excessive blood collection. The skin incision typically is closed with sutures or skin staples.


Recovery from a bone graft is related to healing of the wound. This usually takes a couple of weeks. You may bear weight on the leg from which the bone was taken if the foot/ankle surgeries done at the same time allow for it. Bending the knee is usually allowed immediately after a proximal tibial bone graft.

Risks and Complications

Potential problems after a bone graft include infection, fracture, and pain related to the procedure.

Is bone autograft (taken from the patient) better than allograft (taken from a donor)?

Because there are so many factors involved, the answer to this question varies. It is best to discuss your specific situation with your foot and ankle orthopaedic surgeon.

If a proximal tibial bone graft is taken from my knee, will this prevent me from being able to have other procedures in this area, such as knee replacement?

No. Most surgeries to treat knee problems can be done safely in the future.

Does harvesting a tibial bone graft damage the knee joint?

No. The graft is taken just below the actual joint with great care taken to protect the knee at all times.


Original article by Michael Salamon, MD
Contributors/Reviewers: Jamal Ahmad, MD; Nicholas Cheney, DO; David Lee, MD

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