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
A bone graft may be done 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
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Blood clots
- Nerve damage
- Rejection of a donor graft
- Anesthesia reaction
- Rarely, 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:
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 medications. You may be asked to stop taking some medications up to 1 week before the procedure.
- 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.
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.
An incision will be made in 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. Plates and screws may be used during the procedure to immobilize the bone. A cast or brace may be needed after the procedure.
How Much Will It Hurt?
Anesthesia prevents pain during the procedure. Pain and discomfort after the procedure can be managed with medication.
Average Hospital Stay
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 hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not 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. Your doctor will track progress with x-rays.
Call Your Doctor
Call your doctor if any of the following occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you were 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
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Ortho Info—American Academy of Orthopedic Surgeons
The Canadian Orthopaedic Association
When it Hurts to Move—Canadian Orthopaedic Foundation
Bone and tissue transplantation. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00115. Updated January 2009. Accessed June 26, 2015.
Bone grafting. The Cleveland Clinic website. Available at http://my.clevelandclinic.org/services/orthopaedics-rheumatology/treatments-procedures/bone-grafting. Updated 2015. Accessed June 26, 2015.
Bone grafts in spine surgery. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00600. Updated July 2010. Accessed June 26, 2015.
Last reviewed June 2016 by Donald Buck, 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.