Bone Graft

  • Definition

    During a bone graft, a donated piece of bone is added to the site of a fracture or other bone defect. The new bone can spur bone growth, bridge a gap in a bone, provide support, and aid in healing. The new bone may come from another part of your body (autograft) or from another person (allograft). Rarely, synthetic grafts, which are not bone, are also used.
    Iliac Crest Graft Harvest
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  • Reasons for Procedure

    The doctor may recommend a bone graft to:
    • Treat a fracture that is not healing
    • Reconstruct a shattered bone
    • Fill gaps in bone caused by cysts or tumors
    • Fuse bones on either side of a joint
    • Stimulate bone growth to help anchor an artificial joint or other implant
  • Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Bleeding
    • Infection
    • Blood clots
    • Nerve damage
    • Rejection of a graft from another person
    • Anesthesia reaction
    • Rarely, fat particles dislodge from the bone marrow and travel to the lung
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
    • Smoking
    • Drinking
    • Chronic disease such as diabetes or obesity
  • What to Expect

    Prior to Procedure
    Your doctor will likely do the following:
    • Physical exam
    • X-rays of the bone involved
    Leading up to your procedure:
    • Talk to your doctor about your medications. You may be asked to stop taking some medicationss up to one week before the procedure, like:
      • Aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
      • Blood thinners
      • Anti-platelets
    • Review with your doctor any herbs or supplements that you take. You may be asked to stop taking some.
    • Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
    • Arrange for help at home after returning from the hospital.
    Anesthesia
    Depending on the procedure, you may receive:
    Description of the Procedure
    The method of treatment depends on the type and location of the bone injury or defect and the type of graft you will be receiving.
    Most bone graft procedures use your own bone. The bone is often taken from the iliac crest. This is the bone at your hip, about where you would wear a belt. An incision is made over the part of the bone that will be removed. A special bone chisel will remove the piece of bone. This incision is then closed.
    The doctor will cut through the skin covering the area in need of repair. Any scar or dead tissue will be removed from the area. Your bone will then be reconstructed with the graft. The doctor may need to immobilize the bone. Plates and screws may be used during the procedure to immobilize the bone. A cast or brace may be needed after the procedure.
    After Procedure
    An x-ray may be taken to make sure the bone is in the correct position.
    How Long Will It Take?
    The length of your surgery will depend on the repair needed.
    How Much Will It Hurt?
    Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed with medication.
    Average Hospital Stay
    Your stay in the hospital will depend on the extent of surgery and your progress.
    Post-procedure Care
    During your stay, the hospital staff will take steps to reduce your chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incisions covered
    There are also steps you can take to reduce your chances of infection such as:
    • Washing your hands often and reminding visitors and healthcare providers to do the same
    • Reminding your healthcare providers to wear gloves or masks
    • Not allowing others to touch your incisions
    Care depends on the procedure and location of the bone graft:
    • Do not smoke. Smoking can delay bone healing.
    • Some grafts can fail. You doctor will track progress with x-rays.
  • Call Your Doctor

    Call your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Nausea and/or vomiting that you can't control with the medications you were given
    • Pain that you can't control with the medications you have been given
    • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
    • Cough, shortness of breath, or chest pain
    • Numbness or tingling at affected site
    If you think you have an emergency, call for medical help right away.
  • RESOURCES

    American Academy of Orthopedic Surgeons http://www.orthoinfo.org

    National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Bone and tissue transplantation. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00115. Updated January 2009. Accessed July 30, 2013.

    Bone grafting. The Cleveland Clinic website. Available at http://my.clevelandclinic.org/orthopaedics-rheumatology/treatments-procedures/bone-grafting.aspx. Accessed July 30, 2013.

    Bone grafts in spine surgery. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00600. Updated July 2010. Accessed July 30, 2013.

    Treatments for bone disorders. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/bone%5Fdisorders/treatments%5Ffor%5Fbone%5Fdisorders%5F85,P00130. Accessed July 30, 2013.

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