Bone Graft Surgery
A bone graft refers to taking bone from some remote location and putting it in a different part of the body. Bone graft taken from your own body is called Autologous bone graft. If the bone is taken from a cadaver, it is called Autogenous bone graft.
Bone grafting is used to fill defects or gaps in bone during the treatment of fractures, or during arthrodesis (fusion) operations. In these cases it is important to have enough bone mass present to get the bone to heal together.
Both autologous and autogenous bone graft material contain the mineral scaffolding for new bone to grow on. That property is called Conduction. Autologous bone graft also has properties of Induction. It contains the living cells that grow bone (osteoblasts) and the chemical proteins that promote the bone growth (bone morphogenic proteins). These are not found in autogenous bone. Therefore, your own bone makes the best bone graft material to use.
Unfortunately, collecting autogenous bone requires an operation on another site in your body. This may add to the pain you have after surgery. It is unusual for the bone graft harvest site to be more painful than the primary surgery site.
You may not be able to provide enough autologous bone graft if there is a large defect that needs to be filled. In that case, autogenous Cadaver bone may be mixed together with your autologous bone.
Iliac Crest Bone Graft
The iliac crest is the bone on your side just above the hip that your belt sits on. That is the common donor site for bone graft. I will use the same side as the foot or ankle, so you will have just one side of you body involved.
When I harvest bone graft there I make an incision 3 – 4 inches in length. The bone is split open, and the cancellous or marrow bone is removed from within. That provides the bone graft. The iliac crest split is then repaired, and the skin closed. The bone graft is then used for the fracture or fusion in the foot or ankle.
Medial Malleolus Bone Graft
The medial malleolus is the bone prominence at the inside of the ankle. Bone graft can be taken from that if only a small amount is going to be needed.
A 2 inch incision is made over that bone, and a “window” is made in the hard cortical bone with a chisel. The cancellous or marrow bone inside is then scooped out. After that, the window is replaced so it will heal back together just like a fracture, and the skin is closed.