Bone Grafts and Substitutes — MCQs

Q: Which site is the most common source for autologous bone grafts?

Iliac crest. **Explanation:** The **Iliac Crest** is the "gold standard" and most common donor site for autologous bone grafting. This is because it provides a rich supply of both **corticocancellous bone** and osteoprogenitor cells. The posterior iliac crest is preferred when a large volume of bone is needed, while the anterior crest is used for smaller grafts due to easier surgical access. **Why the other options are incorrect:** * **Tibial tuberosity:** While it can be used for small amounts of cancellous bone (e.g., in foot and ankle surgeries), the volume available is significantly less than the ilium, and there is a risk of weakening the extensor mechanism. * **Greater trochanter:** This site provides a limited amount of cancellous bone. It is rarely the primary choice unless the surgery is already being performed in the hip region. * **Fibula:** The fibula is the most common source for **vascularized cortical bone grafts**. It is used for structural support (e.g., bridging large bony defects) rather than as a general source of cancellous bone. **High-Yield Clinical Pearls for NEET-PG:** * **Osteogenesis, Osteoinduction, and Osteoconduction:** Autografts are unique because they possess all three properties. * **Complications:** The most common complication of iliac crest harvesting is **chronic donor site pain**. Injury to the lateral femoral cutaneous nerve (Meralgia paresthetica) can occur during anterior harvesting. * **Bone Morphogenetic Proteins (BMPs):** These are the most potent osteoinductive growth factors found within the bone matrix.

Practice by Chapter

Biology of Bone Grafting

Practice Questions

Autografts: Harvesting and Applications

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Allografts: Processing and Applications

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Bone Graft Substitutes

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Vascularized Bone Grafts

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Growth Factors in Bone Healing

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Demineralized Bone Matrix

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Ceramic Materials

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Composite Grafts

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Bone Graft Immunology

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Bone Morphogenetic Proteins

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Tissue Engineering in Orthopaedics

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