Dr. Öğr. Üyesi Görkem Kıyak
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Fractures & Trauma
Bone graft
What an orthopaedic bone graft is, how new bone is encouraged to form in a gap, a nonunion or a fusion, how autograft, donor bone and synthetic substitutes compare, who needs one, approximate costs in Turkey against the UK, US and Germany, recovery, risks and how to check a hospital.
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Bone graft in Turkey: what it is and how it works
A bone graft is a surgical procedure in which bone or bone-like material is placed where the body needs to grow new bone. The graft is not meant to last unchanged: it acts as a scaffold, and in the case of living bone it also supplies cells and growth signals, while your own bone grows in and slowly replaces it. Orthopaedic surgeons use bone grafts to fill a gap left by a tumour, cyst or infection, to help a fracture that has not united, to join vertebrae in spinal fusion, and to rebuild bone around a joint replacement or a joint that has been fused. Hospitals in Turkey offer these operations in orthopaedic and spine departments.
This page covers grafting in orthopaedics. Grafts for dental implants are a separate subject. The guide explains how a bone graft works, where the material comes from, what it costs compared with the UK, US and Germany, recovery and how to check a hospital. For related operations see our orthopedics treatments in Turkey.
What problems is a bone graft used for?
Bone usually repairs itself, so a graft is used when that is not enough. The main situations are:
- Nonunion or delayed union: a fracture that has not healed after several months, often because of poor blood supply, movement at the break or infection.
- Bone defects: a hole left after a tumour, cyst or infected bone is removed, or after a severe open fracture with lost bone.
- Spinal fusion: graft packed between vertebrae so that they join into one bone.
- Joint surgery: filling bone loss around a hip or knee replacement revision, or helping a joint fusion such as the ankle or wrist.
- Deformity and reconstruction: adding bone to a corrected or lengthened limb.
When damaged or dead bone has to be removed first, the surgery is described in our guide to resection of the bone, and the graft is placed afterwards or in the same operation.
Where does the bone come from: your own, a donor or a substitute?
Surgeons think about three properties: whether the material builds bone itself (osteogenic), whether it signals the body to make bone (osteoinductive) and whether it works as a scaffold (osteoconductive). Your own bone offers all three; most others offer only some.
| Graft type | Best suited to | Typical limits |
|---|---|---|
| Autograft (your own bone, often from the pelvis, or locally from the surgical site) | Nonunion, large defects, difficult fusions | Needs a second wound; donor site pain; limited quantity |
| Allograft (screened, processed donor bone) | Larger structural defects, spinal fusion, revision surgery | Slower incorporation; small risk of disease transmission and rejection |
| Synthetic substitutes (calcium phosphate, hydroxyapatite, bioactive glass) | Filling contained cavities, extending autograft | No living cells; weaker for large or unstable defects |
| Bone marrow concentrate, demineralised bone matrix, growth factors | Added to a graft to encourage healing | Evidence is mixed; cost and availability vary |
Autograft remains the reference standard for difficult cases because it contains living cells, but the second wound is a drawback, which is why substitutes and allograft are widely used. A surgeon should explain which source suits your case and what happens if the graft does not take.
Does a bone graft work? What the evidence says
For the right indication, yes. Autograft has a long record in healing nonunions and fusions, and good substitutes can reliably fill contained defects. The evidence is more cautious about add-ons such as growth factors and marrow concentrates, where results differ between studies and sites. A graft also depends on surroundings: it needs a stable fixation, a good blood supply and no infection, and smokers and people with diabetes have lower healing rates. A trustworthy hospital will explain these conditions and will not promise that every graft will take.
Bone graft cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for an orthopaedic grafting operation with a hospital stay, not hospital quotes. Each hospital confirms its own price in a written quote.
| Country | Approximate cost range |
|---|---|
| Turkey | €1,500 – €8,000 |
| United Kingdom | €5,000 – €18,000 |
| United States | €10,000 – €40,000 |
| Germany | €4,000 – €15,000 |
What changes the price: the operation the graft belongs to (a spinal fusion or a revision costs far more than filling a small cavity), the graft material (donor bone and substitutes cost more than local bone), the implants, the length of stay, and whether a second donor-site operation is needed. A bone graft price given without imaging is only a guide. A package normally includes the consultation, scans, the operation, implants, stay and medication; ask whether follow-up X-rays and physiotherapy are included.
Who is a good candidate for a bone graft, and who is not?
Good candidates have a clear bone problem that a graft addresses, a stable fixation plan and a healthy enough body to heal. You may not be suited if there is an active infection (it must be cleared first), poor blood supply to the limb, uncontrolled diabetes, heavy smoking that you cannot stop, or severe osteoporosis. Some medicines slow bone repair, including steroids and certain anti-inflammatories, and should be discussed. If a graft is needed for a bone tumour, the plan is set by oncology and orthopaedic specialists together, not by a travel clinic.
How is a bone graft operation done?
The operation is done under general, spinal or regional anaesthesia. The surgeon exposes the area, prepares the bone ends or the cavity by removing scar tissue and dead bone, and places the graft. If your own bone is used it is taken from the pelvis (iliac crest), the shin or the nearby site through a separate incision. The graft is packed or shaped to fit and held with plates, screws, rods or cages, since the graft needs a still environment. Operations take from one to four hours, depending on the site. Some surgeons use a staged method for infected defects, in which a spacer is placed first and replaced with bone a few weeks later.
Bone graft recovery: how long until the bone has joined?
Expect pain and swelling for the first weeks, at the graft site and at any donor site; pelvic donor sites can be sore for weeks when walking. You may stay in hospital for two to five days. Weight bearing and activity are limited according to the operation, often for six to twelve weeks, and physiotherapy starts early. X-rays at six and twelve weeks and again at about six months show whether the graft is joining; solid union may take six to twelve months, and spinal fusions even longer. Most people stay in Turkey for about five to ten days so that the wound and mobility can be checked before flying. Ask about clot prevention for flights, and about who reviews your X-rays at home. Our page on how it works shows how follow-up is arranged.
What results can I realistically expect?
Success means the bone unites on follow-up scans, pain eases and the limb or spine becomes stable. You will not see a visible change from the graft; you will see a scar, and the benefit is shown on X-ray and in function. Not every graft takes; if one fails, a further operation may be needed. Recovery depends on the cause: a nonunion that has had infection takes longer than a clean defect. Ask the surgeon what success rate the unit has with your type of graft and how it is measured.
Risks and complications of bone graft surgery
Every operation carries risks. For bone grafting these include infection, bleeding, pain and numbness at the donor site, failure of the graft to join (nonunion), absorption of the graft, and blood clots in the legs. Allograft carries a very small risk of disease transmission, minimised by donor screening and processing. Spinal grafting can add nerve irritation. Anaesthetic risks apply to all operations. The NHS and the American Academy of Orthopaedic Surgeons describe these risks; ask the hospital how it manages complications and who will treat you after you leave Turkey.
How to choose a hospital and surgeon, and what to ask
Check that an orthopaedic or spine surgeon with experience in your type of graft plans the operation, that the hospital has theatre imaging, bone-bank or implant supply from licensed sources, intensive care and physiotherapy, and that you receive a written plan and price before paying a deposit. Red flags include a firm plan without scans, claims that the graft always works, no information about the source of donor bone and no follow-up plan. Send your scans through our free quote page for a written plan.
Questions to ask the clinic:
- Which graft material do you propose and why?
- Is a second incision needed for a donor site?
- When can I walk, put weight on the limb and fly?
- What happens if the graft does not unite?
Hospitals with Orthopedics in Turkey
Frequently asked questions
A bone graft places bone or a bone-like material where new bone is needed. It acts as a scaffold, and your own bone grows into it and gradually replaces it, helping to close a gap, heal a nonunion or join a fusion.
It may come from your own body, often the pelvis (autograft), from screened donor bone (allograft), or from synthetic substitutes such as calcium phosphate. The choice depends on the size and site of the defect.
Approximate ranges are €1,500 to €8,000 in Turkey, against about €5,000 to €18,000 in the UK. The price depends on the operation, the material and the stay, and the hospital confirms it in a written quote.
In the right cases, yes: grafts heal many nonunions, fill defects and support fusions. Success depends on stable fixation, blood supply, no infection and not smoking, and some grafts do not take.
Weight bearing is usually restricted for six to twelve weeks, and solid union may take six to twelve months. Pelvic donor sites can be sore for several weeks when walking.
You are asleep or numbed for the operation. Afterwards pain at the graft and donor site is expected and is managed with regular painkillers; it usually eases over the first weeks.
Autograft is your own bone, which contains living cells but needs a second wound. Allograft is donor bone, processed and screened, which avoids the second wound but incorporates more slowly.
The principle is similar, but orthopaedic grafts treat limbs, joints and the spine and use different sites, sizes and fixation. Dental grafts rebuild the jaw before implants and are a separate procedure.
Possible problems include infection, bleeding, donor-site pain, the graft failing to join or being absorbed, and blood clots. Allograft carries a very small risk of disease transmission.
About five to ten days is usual so that the wound, pain and mobility can be checked before you fly. Spinal or complex operations may need longer.
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