Definition

During bone grafting donated 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 the patient (autograft) or from another person (allograft). Rarely, synthetic grafts, which are not bone, are also used.


Parts of the Body Involved

Any bone in the skeletal system may receive a bone graft. Donor sites include the iliac crests (pelvis) and very rarely the tibia (lower leg). The doctor will determine what type of bone graft will work best for your situation.

Iliac Crest Graft Harvest

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Reasons for Procedure

The doctor may recommend a bone graft to:

  • Treat a fracture that does not heal
  • Reconstruct a shattered bone
  • Fill gaps in bone caused by cysts or tumors
  • Fuse bones on either side of a joint, often in the spine
  • Stimulate bone growth to help anchor an artificial joint or other implant

Risk Factors for Complications During the Procedure

Chronic conditions, advanced age, and smoking increase surgical risks.


What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • X-rays the bone
  • Refer you to an orthopedic surgeon

In the days leading up to your procedure:

  • Review with your doctor any medications, herbs, or supplements that you take. You may be asked to stop taking some drugs.
  • Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
  • Arrange to have someone drive you home after the procedure.
  • Arrange for help at home after returning from the hospital.
  • Plan to wear comfortable clothing on the day of your procedure.

Anesthesia

General anesthesia or local anesthesia will be used, depending on the procedure.

Description of the Procedure

The method of treatment depends upon the type and location of the bone injury or defect, and the type of graft you will be receiving.

If you are donating your own bone cells, the doctor will either insert a needle into the bone and remove marrow cells or cut the skin and take out part of the donor bone.

The surgeon cuts through the skin covering the area in need of repair. He or she will remove any scar or dead tissue and reconstruct your bone with the graft. Screws and or plates may be used to hold the graft in place.

After Procedure

Depending upon the location of the graft, the doctor may immobilize the bone using a internal fixation such as a plate and screws, a cast, or brace. He or she will probably order another x-ray to ensure the bone is in the correct position.

How Long Will It Take?

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

Will It Hurt?

Anesthesia prevents pain during the procedure. Pain medication will relieve discomfort during your recovery.

Possible Complications

  • Fat particles dislodge from the bone marrow and travel to the lung (this is rare)
  • Blood clots may develop in the veins of the pelvis or leg, dislodge, and travel to the lung
  • Infection
  • Bleeding
  • Anesthesia reaction
  • Nerve damage
  • Rejection of graft from another person

Average Hospital Stay

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

Postoperative 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.

Outcome

The goal is for the bone to heal without additional intervention. Some grafts fail. The doctor will monitor the healing process with x-rays.


Call Your Doctor If Any of the Following Occurs

It is essential for you to check your recovery once you leave the hospital. That way, you can alert your doctor to any problems. If any of the following occur, call your doctor:

  • Pain not relieved by medication
  • Fever, chills, or other signs of infection
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain
  • Severe nausea or vomiting
  • Numbness and tingling