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Bone Graft

Definition

A bone graft adds a piece of bone to the site of a fracture or other bone problem. This can help repair and rebuild damaged bone. The new bone may come from another part of the body or from another person. Rarely, man-made grafts are also used.
Iliac Crest Graft Harvest
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Reasons for Procedure

A bone graft may be done to:
  • Treat a fracture that is not healing
  • Rebuild a shattered bone
  • Fill gaps in bone caused by cysts or tumors
  • Fuse bones on either side of a joint
  • Speed bone growth to help anchor a man-made joint or other implant

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Nerve damage
  • Rejection of a donor graft
  • Fat particles that come apart from the bone marrow and travel to the lung (rare)
Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery

Anesthesia

The doctor may give:

Description of the Procedure

The graft method depends on the type and site of the bone injury or problem. It also depends on the type of graft a person gets.
Most bone grafts use a person's own bone. Often, the bone is taken from the bone at the hip, about where a belt would be worn. A cut is made over the part of the bone that will be removed. A special bone chisel will remove the piece of bone. The cut is then closed.
A cut will be made in the skin of the site in need of the graft. Any scar or dead tissue will be removed from the site. The bone will then be rebuilt with the graft. Plates and screws may be used to keep the bone in place. A cast or brace may be needed after the graft.

After Procedure

An x-ray may be taken to make sure the bone is in the right place.

How Long Will It Take?

How long it takes will depend on the repair.

How Much Will It Hurt?

Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can manage pain.

Average Hospital Stay

The length of stay will depend on the repair that was done.

Post-procedure Care

At the Hospital
The staff may give you pain medicine right after the procedure.
During your stay, staff will take steps to lower your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
You can also lower your chance of infection by:
  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home
It will take a few weeks or months to heal. It depends on the repair that is done. Physical activity may need to be limited during recovery. You may need to ask for help with daily activities and delay return to work.

Call Your Doctor

Call the doctor if you are not getting better or you have:
  • Signs of infection, such as fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge
  • Nausea and vomiting
  • Pain that you cannot control with medicine
  • Pain, burning, urgency or frequency of urination, or blood in the urine
  • Cough, problems breathing, or chest pain
  • Numbness or tingling at the site
  • New or unexpected symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov
Ortho Info—American Academy of Orthopedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES

The Canadian Orthopaedic Association
http://www.coa-aco.org
When it Hurts to Move—Canadian Orthopaedic Foundation
http://whenithurtstomove.org

References

Amanatullah DF, Strauss EJ, et al. Current management options for osteonecrosis of the femoral head: part II, operative management. Am J Orthop (Belle Mead NJ). 2011 Oct;40(10):E216-25.
Bone and tissue transplantation. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00115. Accessed September 28, 2020.
Bone grafting. The Cleveland Clinic website. Available at http://my.clevelandclinic.org/services/orthopaedics-rheumatology/treatments-procedures/bone-grafting. Accessed September 28, 2020.
Bone grafts in spine surgery. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00600. Accessed September 28, 2020.

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