To try to find a solution to the high complication rate associated with harvesting bone graft from the iliac crest, a retrospective and prospective study was undertaken to document bone grafting from the proximal tibia in 37 adult patients undergoing a variety of foot procedures. The hospital charts of 17 patients were evaluated retrospectively for complications (mean follow-up of 27 months), while 20 patients were assessed prospectively by means of a questionnaire (mean follow-up of 7 months). There was an overall complication rate of 10.8%, 5.8% in the retrospective group and 15% in the prospective group. All complications were minor and resolved.

Although our overall complication rate is slightly higher than in similar studies, ours is the only prospective study that actively followed the healing of patients’ donor sites. We recommend the proximal tibia as an alternative harvest site. Contrary to popular belief, the proximal tibia provides a large volume of cancellous graft material.