Bone Grafting, Its Principle and Application: A Review

Abstract

Bone grafting is a surgical procedure that replaces missing bone through transferring bone cells from a donor to the recipient
site and the graft could be from a patient’s own body, an artificial, synthetic, or natural substitute. Bone grafts and bone graft
substitutes are indicated for a variety of orthopedic abnormalities such as comminuted fractures (due to car accidents, falling
from a height or gunshot injury), delayed unions, non-unions, arthrodesis, osteomyelitis and congenital diseases (rickets, abnormal
bone development) and are used to provide structural support and enhance bone healing. Autogenous, allogeneic, and artificial
bone grafts are common types and sources of grafts and the advancement of allografts, synthetic bone grafts, and new operative
techniques may have influenced the use of bone grafts in recent years. Osteogenesis, osteoinduction, osteoconduction, mechanical
supports are the four basic mechanisms of bone grafting and help bone tissue to regenerate completely. A bone graft can be
harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs, and sternum. An ideal bone graft substitites
should be biologically inert, readily available, must possess osteogenic, osteoinductive and osteoconductive properties, provide
mechanical support, easily adaptable in terms of size, shape, length and substituted by the host bone. Bone banks are the source
of bone grafts and implants and necessary for providing biological material for a series of orthopedic procedures. Bone grafts
and implants can be selected as per clinical problems, the equipment available and the preference of the surgeon. A search for an
ideal bone graft is on and may continue from time to time.