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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The doctor may recommend a bone graft to: Treat a fracture that is not healingReconstruct a shattered boneFill gaps in bone caused by cysts or tumorsFuse bones on either side of a jointStimulate bone growth to help anchor an artificial joint or other implant
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: BleedingInfectionBlood clotsNerve damageRejection of a graft from another personAnesthesia reactionRarely, fat particles dislodge from the bone marrow and travel to the lung
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
SmokingDrinkingChronic disease such as diabetes or obesity
Your doctor will likely do the following: Physical examX-rays
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:
or other non-steroidal anti-inflammatory drugs
(NSAIDs)Blood thinnersAnti-plateletsReview 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: General anesthesia
—You will be asleep.
Local anesthesia—The area will be numbed.
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.
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
Care depends on the procedure and location of the bone graft: Do not smoke. Smoking can delay bone healing.Some grafts can fail. You doctor will track progress with x-rays.
Call your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision siteNausea and/or vomiting that you can't control with the medications you were givenPain that you can't control with the medications you have been givenPain, burning, urgency or frequency of urination, or persistent bleeding in the urineCough, shortness of breath, or chest painNumbness or tingling at affected site
If you think you have an emergency, call for medical help right away.
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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