Bone grafting is a surgical technique you commonly see in spinal and orthopedic procedures. Traditionally, a bone graft is performed by taking bone from the patient. The material is an autograft and serves as the primary graft material used during the surgery. However, this option often led to a lot of issues. Many donors experience pain in the affected site. Some end up developing an infection. Scarring was also bad. The limited supply of the material was also a source of concern, as it limited options for the surgery. These issues drove doctors to find better ways to perform the procedure. Today, surgeons have four main types of bone grafts that they can use.
The Four Main Types
Patients who might be under a bone graft might use bone graft materials from any of the following sources:
- Autograft
- Growth factor
- Allograft
- Synthetic
Let’s dive into the four types of bone grafts so you’ll know the composition and sources involved in each one.
Autograft
When it comes to the gold standard, an autograft is the best option for patients. The material is also called a cancellous bone graft, which involves harvesting the material from the patient’s cortical or cancellous bone. The material contains live cells. The location of the harvest site also offers easy access, so it’s readily available. For patients going into the OR for foot or ankle surgery, doctors will remove autografts from the same leg where the bone graft will go. The procedure will involve the use of bone harvested from the heel bone or calcaneus. Sometimes, the material was harvested from the lower fibula or tibia (leg bones).
Allograft
This is the bone graft that contains cells harvested from cadavers or tissue donors. It involves the removal of human tissue from cortical and cancellous bone. However, since it comes from cadavers, the skin and bones are thoroughly cleaned and disinfected. Once that step is done, in case of the bones, they are processed into powders. Some also process them into shaped implants or blocks, or even further to remove any mineral components present. Allograft processing can be done by isolating and maintaining live bone marrow cells.
Growth Factor
The bone graft product has specific proteins in this case. Those proteins include bone morphogenetic protein or BMP. The proteins positively influence the formation response of the bone. When the bone grafting is performed, a porous scaffold is used to boost bone formation response. Growth factor products are made of manufactured growth factor component and a porous material for absorbing the fluid. The material also works as a scaffold to aid bone formation.
Synthetic
This bone graft category includes many types of grafts that come from man-made materials. Synthetic bone graft materials were designed to be an alternative solution to autograft. These are available in granules and blocks.
Material Selection
Talk to your doctor about your options. That way, you can choose the material that’s right for you. Your surgeon can also walk you through what to expect, as well as the pros and cons of each option.
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