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Author Topic: Iliac crest bone graft  (Read 11643 times)

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Offline roze87

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Iliac crest bone graft
« on: January 19, 2011, 09:44:37 PM »
Hi

To cut a long story short, I am due to have a bone graft taken out of BOTH my hips and stuffed in the hole where my surgeon butchered up my left knee and misplaced the screw after his 3rd,..and final acl recon. There is alot of history with this knee ie initial lateral tibial plateu fracture, failed acl recon due to infection, and acl failure now i hav a loose screw in there floating around and have no acl and lateral collateral ligament,a plc and acl reconstructions will follow...so i am not new to knee surgery

I am new to this however, i believe this is the last of my chances now, and I am exceptionally nervous about this operation in 1 weeks time. My new surgeon is going to take a bone graft from both my hips, and graft it in the rotten knee and take the floating screw out. I have been warned of the pain. Can someone who has had similar operaiton shed some light on what to expect eg, the pain in my hip, i am led to beliieve is worse then the knee sight.

Just any comments at all on any thing to do with a hip bone graft, preferably from someone with first hand experience would be great!

Thanks!
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline missmyknee

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Re: Iliac crest bone graft
« Reply #1 on: January 19, 2011, 11:19:08 PM »
Hi

I had an iliac crest bone graft done in October. It was done to regraft a nonunion triple ankle fusion. I believe there are 2 ways to do an iliac bone graft. One from the anterior ( front side) and one posterior. Incision size varies. Mine was done posteriorly. I have a 6 inch incision to my back left hip/upper bum. I won't lie to you, it is very painful. It was was more painful post-op than my fusion site. There is just no way to move your body, such as using bedpan or commode, without pain. I was in the hospital 5 days . It took about 4 weeks to move without pain, most of the time. There are some instances, even now, where I can feel discomfort. My OS said it would take several months to recover from the bone graft site. I wonder why your OS would need to take bone from both hips and not one, for grafting one area. I had one site to be used for 3 joints in the ankle.

Sorry I couldn't say it was not painful. I knew it was going to be painful beforehand and just prepared myself mentally to handle the pain.

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline clarky_vl

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Re: Iliac crest bone graft
« Reply #2 on: January 19, 2011, 11:58:41 PM »
Hey,

I had removal of screws from previous ACL revision and the Iliac crest bone graft in february, around 4 months before having the second stage of the ACL revision. I had it from the front of the hip (this is more common I believe, so I assume you will be having yours harvested from the same part as me).

My incision is around 10cm long I think, and like missmyknee says, this is very painful, the hip will be the most painful out of the two surgery sites, although both will be awkward, so prepare to be have a fair amount of pain and to have difficulty doing most things at first!

Almost a year after the bone grafts were taken I find that it feels pretty good, although after sitting for any length of time it is then uncomfortabe to walk around the area of the scar, and it remains very sensitive on the iliac crest right where the bone was taken when it has any pressure on it, I can't really stand that, so things like sleeping on that side I kind of avoid now (a pain, as I am a side sleeper  :P )

I also wonder why your surgeon requires both hips? I had bone taken from my left hip for my last staged revision, but as the revision ultimately failed again, I will be needing another two stage revision. I will have the removal of screws and bone grafts in march, but will need them taken from my right side this time. I am not looking forward to having this done at all, especially it being on the opposite side to the knee, so I can't imagine how you must feel facing both sides at once!

For the initial post op pain in the hip, see if your surgeon might be willing to leave a tubey thing feeding directly into the wound through which local anaesthetic can be injected into.

Any questios orthings imight be able to help you with, just ask  :)

Vicky
11/10/07 ACLr-hamstring, lat meniscectomy, microfracture
29/7/08 ACL revision-hamstring/LARS
7/7/09 ACL revision-quad/LARS
20/2/10 Screws out, bone grafts, arthroscopy.
6/7/10 ACL revision-BPTB allograft
14/3/11 Screws out, bone grafts, arthroscopy.
Then: ACL revision + extra-articular repair

Offline roze87

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Re: Iliac crest bone graft
« Reply #3 on: January 22, 2011, 07:57:46 PM »
Thank you for sharing your experiences and the honesty is appreciated also. Yes my surgeon is taking bone graft from BOTH of my anterior iliac crests (scary) due to the hole in my knee is so bad. Post op wound infection was left undiagnosed for way too long, all the while rotting my knee away. Thus I have a great deal of anxiety related to this! Clarky_vl - Im so sorry for you that your operation failed. Having had failed knee surgery myself i empathise with you, and, ultimately this is my biggest, and, i feel very realistic fear. May I ask what were the implications that caused your operation to fail? How long were you in hospital for?

Were you on crutches? How do they know if it has worked, is it an xray? Did you see a physio?

Other than that, my initial fear is related to practical tasks, such as sleeping. I cant lie on my back for long as it aches as it is. And...washing myself, and my hair! i am 23 yr old female and know that might seem vain but i am so scared as not to get the wounds wet so to prevent infection, how long did it take to heal so you could shower? Also, what pain relief were you given to go home with? How long can i expect to be off work? (office) Surely my knee is going to continue to waste away as i lie there motionless for a month?!

Missmyknee (me too!) - how r u now? Without insulting your history, was this operation a success story?


Thanks again

Rose (in the uk)
06/04 Fell - Fractured tiibial plateau, femur, patella, torn acl
ORIF and bone graft of tibial plateau
09/08 failed acl recon due to wound infection
06/10 failed revision acl with pcl/lcl/plc damage
now facing multiligament surgery

Offline clarky_vl

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Re: Iliac crest bone graft
« Reply #4 on: January 23, 2011, 02:25:07 AM »
Hey Rose,

Ah I see, so sorry to hear of the infection you had how that has left your knee.

The bone graft procedure itself was very successful for me, as I said I had it around 4 months before the revision, they didn't really check the bone healing at all in fact, was just told after the ACL revision that the bone had healed really well and was solid. I am in the UK also, and found my consultant and that hospital don't dish out xrays and other scans unless they have to, so I am not sure if a normal x-ray will actually show the bone to have healed or not, but I think the chance of you rejecting bone tissue, especially your own, is very very slim I was told it has very simple healing- basically just like an ordinary fracture.

the reason I require this procedure to be repeated is that the last ACL revision (the 2nd stage) failed (my body's fault- hypermobility issues)and the tunnels and hardware from that is very big, there isn't enough bone stock to do the next revision and other procedures so lucky me I am back to where i was right before all of this. Unfortunately I know from your history that you are all too familiar with this rubbish too.

yes I was on crutches, but this was not because the bone grafts needed it too heal (as in, no period of NWB exactly...) but you wont be able to weightbare fully or much at all through the leg, the knee will be sore of course, but surprisingly for me I found it hard to put much weight or certainly motion if that makes sense, through the bone graft harvest site. It was a real balancing act between the knee and the hip, so yes, crutches for however long you need them and the knee and hip are uncomfortable for- a good few weeks for me, and that was with a good leg too (I have no idea how that is going to work out this time using my opposite leg, or indeed for you...)

I was in hospital for 5 days/nights, though it would only have been around 2 just for the procedure I had, but due to wound troubles this was extended. I think this was actually lucky looking back as my pain was much more under control when I got home.

In hospital I was given a morphine PCA and codeine/diclofenac, then I was sent home with the codeine/diclofenac, and a couple of bottles of oral morphine. As I said in my previous post too- ask about the possible anaesthetic injected into the area!

My surgeon said he usually signs people off work for 3 weeks at least for this procedure, but I was at school at the time so worked out my own return etc

Dont worry I am the same with the washing and hair, I still wash it every day after surgery (when I feel up to it), just in a modified way at first. However showering or cleaning after knee surgeries is always I think easier for me as my downstairs bathroom is arranged in a way so it is easy to clean and wash and my hair without necessarily getting into the shower (luckily, as it took a couple of weeks to be able to get into and out of the actual bath/shower properly!). Is your shower a walk in one? Those are much easier!

I had my dressings covered with a (very successful!) waterproof layer of dressings which worked fantastically- Ask for those, they'll make it soooo much easier! I also needed very regular changes to the dressings and wound checks due to the wound problems I had.

I actually kept the dressings on my hip for quite a while because the wound happens to be along the line of clothing such as skirt and trouser waistbands, and I counldn't stand the thought of that at first- especially with the area being so sore.

I don't really know what to say about the sleep thing, I will be in the same position as you after my surgery, and I also find it awful sleping on my back. I guess we wont really have a choice, believe me you wont feel at all comfortable lying on your side or front.

Also, I didn't have physio after this surgery last time, I think my surgeon often thinks of physio as pointless and I didn't have a physio to push for it going into it, however I do this time, and he is adament that I should have phyio after this surgery, so he is going to make sure i nag my new surgeon into referrig me back to after the surgery. He says that even if we can only keep a tiny bit of muscle strength going into the second stage, it will make it so much easier the other side. Otherwise, yes you are right, your leg will just sit their wasting away. I guess the same goes for you, so I would advise you to ask for physio if you arent automatically sent for it.

Hopefully this answered your questions, obviously yours will be a different experience, but hopefully this has given you a bit of an idea of what to expect or put you at ease with some things a little? Anything else you think of just ask  :)

Vicky
11/10/07 ACLr-hamstring, lat meniscectomy, microfracture
29/7/08 ACL revision-hamstring/LARS
7/7/09 ACL revision-quad/LARS
20/2/10 Screws out, bone grafts, arthroscopy.
6/7/10 ACL revision-BPTB allograft
14/3/11 Screws out, bone grafts, arthroscopy.
Then: ACL revision + extra-articular repair

Offline missmyknee

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Re: Iliac crest bone graft
« Reply #5 on: January 24, 2011, 04:47:46 AM »
Hi Rose

It's still a little early to claim my surgery a success. I have 8 weeks before I have a CT scan to show if I've achieved fusion. This is my 3rd attempt at having this fusion. The first one took bone graft from my heel. The second attempt took bone graft from my foot and artificial bone. The third one is the iliac crest. I guess the third times a charm .lol

I hope everything goes well for you. Keep your pain meds on schedule to stay ahead of the pain.

Good Luck  ;D

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline Karlstringer

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Re: Iliac crest bone graft
« Reply #6 on: April 18, 2015, 01:41:43 PM »
Hi all I'm about to have lilac crest bone graft done to fill holes made after a 2nd failed ACL revision. Does anyone know how long I will be in hospital for also the pain as I carnt have morphine .
« Last Edit: April 18, 2015, 01:46:20 PM by Karlstringer »