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Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

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

Factors that may increase the risk of complications include:

  • Long-term medical conditions
  • Advanced age
  • Smoking

What to Expect

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.

Depending on the procedure, you may receive:

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.

An x-ray may be taken to make sure the bone is in the correct position.

The length of your surgery will depend on the repair needed.

Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed with medication.

Your stay in the hospital will depend on the extent of surgery and your progress.

Care depends on the procedure and location of the bone graft:

  • Follow your doctor’s instructions for changing the dressing and showering.
  • Do not smoke. Smoking can delay bone healing.
  • Some grafts can fail. You doctor will track progress with x-rays.
  • Be sure to follow your doctor’s instructions .

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_disorders/treatments_for_bone_disorders_85,P00130. Accessed July 30, 2013.

Last reviewed June 2013 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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