A bone transplant or bone graft is a medical procedure performed by filling the damaged part of the bone with new bone or bone replacement. Bone grafts aim to repair and reshape damaged bone.
Bone consists of cells that play an important role in maintaining the integrity of bone shape. When a bone is broken, bone cells grow to repair and grow the missing piece of bone. However, if the bone damage is severe enough, a bone graft will need to be performed so that the bone can fully recover.
In performing a bone graft, the orthopedic doctor will use a bone that comes from inside the body, such as the ribs, pelvis, or wrist (a bone graft). autograft). Sometimes a bone graft also uses the bone tissue of another person or a donor (graft allograft).
Goals andBone Graft Indications
There are several conditions that cause doctors to recommend a patient undergo a bone graft, namely:
- Fractures that don't get better despite treatment.
- Fractures that occur in the joints.
- Bones that are damaged as a result of an injury, such as a fall or car or motorcycle accident.
- Bones damaged by infection or certain diseases, such as bone cancer or osteonecrosis.
Bone grafts are also performed to regrow bone tissue around an implant that was implanted through surgery, for example during joint replacement surgery. Sometimes bone graft procedures are performed as part of spine surgery and dental surgery.
Warning Before Bone Graft
The following are some of the conditions that patients need to be aware of before undergoing a bone graft procedure:
- Allergy to anesthetics.
- Are taking certain medications, including supplements or herbal remedies.
- Have a history of blood clotting disorders.
- Suffering from diabetes and autoimmune diseases.
Before surgery, tell your doctor if you have any of these conditions.
Preparation Before Bone Graft
The doctor will explain to the patient about the bone graft procedure that will be carried out, its benefits, and complications that can occur after the operation. The doctor will also perform an overall physical examination, including blood pressure, heart rate, and body temperature.
Next, the patient will undergo blood tests to detect diseases that can affect the patient's condition during and after surgery. Scanning tests, such as X-rays, CT scans, and MRIs, are also done so that doctors know the condition of bone damage in detail.
Prior to bone graft surgery, the doctor will advise the patient to:
- Fasting for 8 hours.
- Quit smoking.
- Stop taking blood-thinning medications, such as warfarin or aspirin, to prevent heavy bleeding during surgery.
In addition, the doctor will advise the patient to be accompanied by a family member or close relative during and after the procedure, as well as to take the patient home. This needs to be done because the bone graft procedure will limit the patient's ability to move, so they must always be accompanied.
Bone Graft Procedure
The length of the bone graft procedure depends on the condition of the fracture, the type of bone graft used, and the patient's overall condition.
The following are the steps in the bone graft surgery procedure:
- The patient will lie supine on the operating table.
- The doctor will install an IV that is used to deliver anesthetics and other medicinal fluids.
- The anesthesiologist will give general anesthesia or general anesthesia, so that the patient will fall asleep during the operation. The doctor will monitor the patient's heart rate and blood pressure.
- If a bone graft is taken from a part of the patient's body (autograft), then the orthopedic doctor will perform an additional procedure to take bone tissue from the patient's body first.
- The doctor will shape the bone to be grafted according to the part of the damaged bone.
- After the surgical area is cleaned, the doctor will make an incision around the broken or damaged bone.
- The doctor will insert new bone or bone replacement between the two broken bones. For some conditions, doctors use special pens to keep the bones from moving and growing properly.
- After the bone graft is complete, the doctor will stitch and close the surgical wound. cast or splint It is usually used to support the bone during healing.
Maintenance After Bone Graft
After undergoing a bone graft, the patient will be placed in the recovery room and hospitalized for several days. The doctor will monitor the patient's blood pressure and heart rate, as well as administer pain medication and blood thinners to prevent blood clots after surgery.
During the recovery period, the doctor will regularly monitor the condition of the bones with X-rays and remove the wound stitches for at least a week after surgery. The patient is allowed to go home after the doctor makes sure the patient's condition is stable.
The doctor will prescribe medication and give instructions about what the patient can do while recovering at home. Some things that can be done are:
- Get plenty of rest and don't move too much.
- Make sure the surgical area is clean and dry. Change the bandage regularly according to the instructions given by the doctor or nurse.
- Use a cold compress to prevent inflammation. In addition, position the operated leg or arm higher than the heart when lying down, to prevent the risk of clots
- Consume foods and drinks high in calcium and vitamin D, such as milk, cheese, or yogurt.
- Check regularly with an orthopedic doctor to monitor the bone healing process.
There are several things that should not be done while the patient is undergoing the recovery process at home, including:
- Smoking, because it can inhibit the bone healing process.
- Doing vigorous exercise, such as long-distance running, for more than six months.
Patients are also advised to undergo physiotherapy to restore the strength and flexibility of the muscles of the body parts undergoing bone grafts. Patients should contact their doctor immediately if they have a high fever, pain that can't be treated with painkillers, and the surgical wound is swollen.
The length of the recovery period depends on the condition of the fracture, age, and the size of the bone graft. However, patients generally take two weeks to more than a year to fully recover and return to normal activities.
risk and Bone Graft Complications
Bone graft procedures are generally safe. But like any surgical procedure, this procedure carries the risk of bleeding, infection, or side effects from the anesthetic used, such as an allergic reaction. Several other complications can also occur after the patient undergoes a bone graft procedure, including:
- Prolonged pain
- Inflammation in the operating area
- Nerve injury
- Permanent disability
Bone grafts are also at risk of failure when the damaged bone rejects the cells from the new bone, so the bone does not grow and develop properly. This rejection mainly occurs in bone grafts allograft.
