Does the posterior iliac crest harvesting technique have lower rate of postoperative complications than anterior iliac crest harvesting technique?: A systematic review

The aim of the current review was to answer this research question: Does the posterior iliac crest (PIC) harvesting technique has lower rate of postoperative complications than the anterior iliac crest (AIC) one. Online electronic databases were searched to detect articles published in English language from 2000 to 2016. Clinical human studies, comprising randomized controlled trials, controlled clinical trials, case series or retrospective studies whose purpose was comparing postoperative complications between AIC and PIC bone graft harvesting was selected. Results: 16 articles were included in this systematic review from1358 relevant articles. A total of 1262 patients have undergone 1297 bone grafting procedure, with AIC (n=944) compared to PIC (n=353). Because of variations in the data presentation, meta-analysis could not be performed. PIC harvestinghas revealed to have lower postoperative complications (pain, gait disturbance, iliac crest fractures and sensory disturbance) than the AIC. However, no definitive conclusions can be drawn, asmost of the included studies were retrospective in nature. Thus, a prospective randomized clinical trial is requiredto substantially answer this significant research question.