For years I’ve had knee pain from being knock-kneed. Now I’m going to have an operation to correct the problem. Part of the procedure involves taking a piece of bone from my pelvis and putting it in the side of the knee joint. I’ve heard the donor site can have more problems than the actual surgical site. Why is that?

Some surgeons say that complications from iliac crest bone graft harvest can be avoided. They advise improved surgical technique can make a difference. Taking too much bone is the first mistake that’s easy to make.

According to Frank Noyes, MD, a well-known orthopedic surgeon from the Cincinnati Sportsmedicine Clinic, no more than 10 mm (less than half an inch) of bone should be removed from one spot. The surgeon must remove the bone carefully without damaging the muscle. Only the outside layer of bone should be taken.

This type of minimally invasive method has the least amount of problems or complications later. Nerve damage, infections, and blood loss can be avoided in this way. Sometimes patients do report pain whenever they bend forward. This usually only lasts for about four weeks while the donor site is healing. Patients are cautioned to avoid this movement.

Patients can get bone donated from a bone bank to avoid any of these complications. The advantage of using the patient’s own bone is the rapid healing that occurs at the operative site.