What Is A Bone Graft? | Orthopaedics

Overview of bone graft

Bone grafting is a surgical procedure that uses the transplanted bone to repair and rebuild diseased or damaged bones. A bone graft is a choice for repairing bones almost anywhere in your body. Your surgeon might take bone from your hips, legs, or ribs to perform the graft. Sometimes, surgeons also use bone tissue donated from cadavers to perform bone grafting.

Surgeons often perform bone grafts as part of some other medical procedure. For example, if you have a severe femur fracture, your healthcare provider might perform a bone graft as part of other needed repairs to your bone. Your healthcare provider may make an incision in your hip to remove a small part of your hip bone and use it for the graft. In some cases, artificial material is used similarly, but this is not a bone graft in the traditional sense. You will usually be put to sleep under general anaesthesia for the procedure.

Alternative names for bone graft

  • Autograft – bone
  • Allograft – bone
  • Fracture
  • Autologous

Types of bone grafts

The two most communal types of bone grafts are:

  • Allograft, which uses bone from a departed donor or a cadaver that has been gutted and stored in a tissue bank.
  • Autograft, which comes from a bone within your body, such as your ribs, hips, pelvis, or wrist

The type of graft used to be contingent on the type of injury your surgeon is repairing.

Allografts are usually used in hip, knee, or long bone rebuilding. Long bones include arms and legs. The advantage is that no additional surgery is needed to acquire the bone. It also reduces the risk of infection, as no additional incisions or surgery are required.

Allograft bone transplantation involves bone that does not have living cells, so the risk of rejection is minimal compared to organ transplants, in which there are living cells. Since the transplanted bone does not contain living marrow, it is not necessary to compare the blood types between donor and recipient.

Why might you need a bone graft?

You may need a bone graft to promote bone healing and growth for various medical reasons. Some specific conditions may include:

  • An initial fracture that your healthcare provider suspects will not heal without a graft.
  • A fracture that you had not previously treated with graft and that did not heal well.
  • Bone diseases, such as osteonecrosis or cancer.
  • Spinal fusion surgery (which you may need if you have an unstable spine).
  • Dental implant surgery (which you may need if you want to replace missing teeth).
  • Surgically implanted devices, as in total knee replacement, to help promote bone growth around the frame.

These can provide a framework for the growth of new and living bone. The hips, knees, and spine are common sites for a bone graft, but you may need a bone graft for not the same bone in your body.

The procedure of bone grafts

Typically, a person will be under general anaesthesia during a bone graft procedure. A surgeon will cut and then place the bone substitute in the damaged area. They may use additional tools and supports to hold the graft in place, including:

  • Thumbscrew
  • Wires
  • Cables
  • Dishes
  • Legs

The surgeon will close the wound with stitches. Doctors will monitor a person for several hours after the procedure. Before the person is discharged, they will also give instructions on how to help prevent infection.

Before the bone graft procedure

Tell your surgeon what medications you are taking. This includes medicines, supplements, or herbs that you bought without a prescription. Follow the instructions on how to stop taking blood thinners, such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), or NSAIDs such as aspirin. These can cause increased bleeding during surgery.

On the day of surgery

  • Follow the instructions about not eating or drinking anything before surgery.
  • Take the medicines your provider has ordered with a small sip of water.
  • If you go to the hospital from home, make sure you arrive at the scheduled time.

After the procedure

Recovery time rests on the injury or defect being treated and the size of the bone graft. Your recovery can take from 2 weeks to 3 months. It will take up to 3 months or more to heal. You may be told to evade extreme exercise for up to 6 months. Ask your provider or nurse what you can and cannot do safely. It will essential to keep the area clean and dry. Follow the instructions on how to shower.

Smoking slows or prevents bone healing. If you smoke, the graft is more possible to fail. Be aware that nicotine patches delay healing.

Risks factors

Risks of a bone graft procedure include:

  • Nerve injury
  • Infection
  • Bleeding
  • Decreased mobility
  • Cosmetic defects
  • Chronic pain
  • Failure of the graft to achieve its goal