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Bone Graft by Debra Wood, RN

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

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

Complications are rare, but no procedure is completely free of risk. If you are planning to have a bone graft, your doctor will review a list of possible complications, which may include:

Bleeding
Infection
Blood clots
Nerve damage
Rejection of a graft from another person
Fat particles dislodge from the bone marrow and travel to the lung (this is rare)
Anesthesia reaction

Factors that may increase the risk of complications include:

Long-term medical conditions
Advanced age
Smoking

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 medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
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:

General anesthesia —You will be asleep.
Local anesthesia—The area will be numbed.

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 medicine will relieve discomfort during your recovery.

Average Hospital Stay

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

Post-procedure Care

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

After you leave the hospital, contact 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 cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
Pain that you cannot control with the medicines 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

In case of an emergency, call for medical help right away.

RESOURCES:

American Academy of Orthopedic Surgeons http://www.aaos.org/
The Cleveland Clinic http://www.clevelandclinic.org/
University of Maryland Spine Center http://www.umm.edu/

CANADIAN RESOURCES:

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

References:

Bone grafting. The Cleveland Clinic website. Available at http://my.clevelandclinic.org/orthopaedics-rheumatology/treatments-procedures/bone-grafting.aspx. Accessed September 8, 2005.
Canale ST. Campbell's Operative Orthopaedics. 10th ed. St. Louis, MO: Mosby, Inc.; 2003.
A patient's guide to understanding bone graft. University of Maryland Spine Center website. Available at: http://www.umm.edu/spinecenter/education/understanding_bone_graft.html. Accessed September 8, 2005.

Last reviewed December 2011 by John C. Keel, MD

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