A bone transplant or bone graft is a medical procedure performed by filling a damaged part of the bone with new bone or bone replacement. A bone graft aims to repair and rebuild damaged bone.
Bone consists of cells that play an important role in maintaining the integrity of the shape of the bone. When a bone is broken, bone cells will grow to repair and grow the missing bone. But if the bone damage is severe enough, a bone graft needs to be done so that the bone can fully recover.
In doing a bone graft, the orthopedic doctor will use bones originating from the body, such as ribs, pelvis, or wrists (autograft graft). Sometimes bone grafts also use other people's bone tissue or donors (allograft grafts).
The Purpose and Indication of Bone Graft
There are several conditions that cause doctors to recommend that a patient undergo a bone graft, namely:
- Broken bones that do not get better despite treatment.
- Broken bones that occur in the joints.
- Bones that are damaged by injury, such as falls or car or motorcycle accidents.
- Bones are damaged due to infection or certain diseases, such as bone cancer or osteonecrosis.
A bone graft is also performed to regrow bone tissue around implants implanted by surgery, for example when a joint replacement surgery. Sometimes bone graft procedures are performed as part of spinal surgery and dental surgery.
Warnings Before Bone Graft
The following are some of the conditions that patients need to consider before undergoing a bone graft procedure:
- Allergy to drugs.
- Currently taking certain drugs, including supplements or herbal medicines.
- Have a history of blood clotting disorders.
- Suffered from diabetes and autoimmune diseases.
Before surgery, inform 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 to be performed, its benefits, as well as complications that can occur after surgery. The doctor will also do an overall physical examination, including blood pressure, heart rate, and body temperature.
Furthermore, patients 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 the doctor knows the condition of bone damage in detail.
Before a bone graft surgery, the doctor will advise the patient to:
- Fasting for 8 hours.
- Quit smoking.
- Stopping the consumption of blood-thinning drugs, such as warfarin or aspirin, to prevent severe bleeding during surgery.
In addition, the doctor will advise the patient to be accompanied by family members or close relatives 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 it must always be accompanied.
Bone Transplant Procedure
The duration of a bone graft procedure depends on the condition of the fracture, the type of bone graft used, and the overall condition of the patient.
The following are the steps in a bone graft surgery procedure:
- The patient will be stretched on his back on the operating table.
- The doctor will place an IV that is used to channel the anesthetic and other drug 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), the orthopedic doctor will perform additional procedures to remove bone tissue from the patient's body parts first.
- The doctor will form a bone that will be grafted in accordance with the damaged bone.
- After the surgery area is cleaned, the doctor will make an incision around the broken or broken bone.
- The doctor will insert a new bone or bone replacement between two broken bones. For some conditions, doctors use a special pen to keep bones from moving and growing perfectly.
- After the bone graft is done, the doctor will sew and close the surgical wound. Casts or splints are usually used to support bones during healing.
Treatment after bone graft
After undergoing a bone graft, the patient will be placed in a recovery room and be hospitalized for several days. The doctor will monitor the patient's blood pressure and heart rate, as well as prescribe pain medications and blood thinners to prevent blood clots after surgery.
During the recovery period, the doctor will monitor the condition of the bones regularly with X-rays and remove stitches at least a week after surgery. Patients are allowed to go home after the doctor ensures the patient's condition is stable.
The doctor will prescribe medication and give instructions on what the patient can do during the recovery period at home. Some things you can do are:
- Get plenty of rest and don't move too much.
- Make sure the wound area is clean and dry. Change the bandage regularly according to instructions given by the doctor or nurse.
- Use cold compresses to prevent inflammation. In addition, position the foot or arm that is operated higher than the heart when lying down, to prevent the risk of clotting
- Consume foods and drinks high in calcium and vitamin D, such as milk, cheese or yogurt.
- Perform routine checks to the orthopedic doctor to monitor the healing process of the bone.
There are some 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.
- Do strenuous exercise, such as long distance running, for more than six months.
Patients are also advised to undergo physiotherapy to restore strength and flexibility in the muscles of the body undergoing bone graft. Patients should immediately contact a doctor if they have a high fever, pain that cannot be treated with pain medication, and the surgical wound is swollen.
The duration of recovery depends on the condition of the fracture, age, and size of the bone graft. However, patients generally need two weeks to more than a year to fully recover and move back to normal.
Risk and Complications of Bone Graft
Bone graft procedures are generally safe. But like every surgical procedure, this action risks causing bleeding, infection, or side effects from the anesthetics used, such as allergic reactions. Some other complications can also occur after a patient has a bone graft procedure, including:
- Prolonged pain
- Inflammation in the operating area
- Nerve injury
- Permanent disability
Bone grafts also run the risk of failure when damaged bone rejects cells from new bone, so the bone does not grow and develop properly. This rejection mainly occurs in allograft bone grafts.
