About Bone Healing

How long does it take my heart to heal?1

Healing time for your heart varies. Although your heart is likely repaired during surgery, you should discuss your heart recovery with your surgeon. As for your breastbone, it still has a long healing process ahead. The healing of the breastbone tends to be the slowest part of the recovery process. Patients essentially experience two operations during open-heart surgery; one on the heart and one on the breastbone.

How long does it take my breastbone to heal?2,3

For healing to occur, bones must be brought together and stabilized. The chest wall is constantly in motion with every breath, cough, sneeze, or bend. To promote faster and overall better healing, it is important to immobilize the breastbone to prevent movement or separation.

In the SternaLock Blu Study, patients that received wire closure had slower rates of healing compared to those with SternaLock Blu. At 3 months post-surgery, 41% of SternaLock Blu patients had sufficient bone healing versus only 16% of patients treated with wires.4,5

Various things, including your general health, quality of bone, activity level, and adherence to your doctor’s instructions, can affect healing times. If non-union (failure of the bone to mend back together) occurs, it may affect healing time considerably.

What factors influence breastbone healing?6

Age, smoking, and high BMI are risk factors that may significantly influence bone healing.

Other factors that can have an impact on how well you heal include:

• Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes
• The use of medications such as steroids or immunosuppressants
• Osteoporosis

As with most surgeries, sternal closure comes with risk, including the risk of infection, implant wear, loosening, screw or plate breakage and delayed or incomplete bone healing. For more information on risks associated with sternal closure using SternaLock Blu see the Patient Risk Information section.

What risks are associated with Sternal Closure?

If the breastbone (sternum) does not heal properly, recovery can be delayed or complications can occur. Complications of the breastbone include infection and pain and may lead to re-operation. You may hear clicking of the breastbone when moving.8 If you hear this or experience discomfort in the middle of your chest, contact your surgeon.

In the SternaLock Blu Study, patients treated with SternaLock Blu experienced fewer breastbone complications compared to patients with wire closure. Breastbone complications experienced by the wire group included infection and removal for pain.4,5 The infographic shows breastbone complication rates over six months.

Possible adverse risks of sternal closure include, but are not limited to, risk of infection, implant wear, loosening, screw or plate breakage and delayed or incomplete bone healing.7 For more information on risks associated with sternal closure using SternaLock Blu see Patient Risk Factors.

How does healing affect pain levels?

Chest pain after heart surgery may be caused by damage to nerves surrounding the breastbone or incision sites. If the breastbone is not immobilized, movement of the chest wall will continue to pinch surrounding nerves, causing chronic pain.

The SternaLock Blu Study followed patients out to six months after surgery and found that when the breastbone completely healed, there was an 85% chance of being pain free.4,5

Bone healing time varies and some heart patients may continue to feel pain or discomfort indefinitely.


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References
  1. http://www.heart-valve-surgery.com/heart-surgery-blog/2012/05/31/heart-healing-cardiac-muscle-after-surgery/
  2. Hatcher, Brian, PhD, and Minya Holderman. “The Importance of Sternal Approximation and Mechanical …” N.p., n.d. Web. 11 July 2017.
  3. Pai S., Gunja N.J., Dupak E.L., McMahon N.L., Roth T.P., Lalikos J.F., Dunn R.M., Francalancia N., Pins G.D., and Billiar K.L., In vitro comparison of wire and plate fixation for midline sternotomies. Ann Thorac Surg, 2005. 80(3): p. 962-8.
  4. CR 0712S (Clinical Study Report) SternaLock Blu Study, 2014-15, an evaluation of rigid plate fixation in supporting bone healing: a prospective, multi-center trial of 236 total patients undergoing full midline sternotomy.
  5. CR 0712E (Economic Study Report) SternaLock Blu Study, 2014-15, an evaluation of rigid fixation in supporting bone healing; a prospective, multi-center trial of 236 total patients undergoing full midline sternotomy.
  6. Fowler, Vance G., Sean M. O’Brien, Lawrence H. Muhlbaier, G. Ralph Corey, T. Bruce Ferguson, and Eric D. Peterson. “Clinical Predictors of Major Infections After Cardiac Surgery.” Circulation. American Heart Association, Inc., 30 Aug. 2005. Web. 11 July 2017
  7. SternaLock Blu IFU
  8. https://www.ctsnet.org/sites/default/files/images/Side-effects.pdf

The information herein is of a general nature and does not represent or constitute medical advice or recommendations and is for general education purposes only. The information includes descriptions of a medical device that a thoracic (heart) surgeon may choose for patients undergoing open-heart surgery.

Zimmer Biomet manufactures medical devices, including metal plates and screws that may be used by your heart surgeon to hold together the sternum (breastbone) after heart surgery. We do not practice medicine; all questions regarding your medical condition must be directed to your doctor(s).

Results with breastbone (sternum) plates and screws (rigid fixation) will vary due to health, weight, activity and other variables. Not all patients are candidates for this product and/or procedure. Only a medical professional can determine the treatment appropriate for your specific condition.

Appropriate post-operative activities will differ from patient to patient. Talk to your surgeon about whether rigid fixation is right for you and the risks associated therewith, including but not limited to the risks of infection, implant wear, loosening, screw or plate breakage or incomplete bone healing.

For a complete list of risks associated with Zimmer Biomet’s rigid fixation system, see Patient Risk Information.

The SternaLock Blu study was funded by Zimmer Biomet.

All content herein is protected by copyright, trademarks and other intellectual property rights, as applicable, owned by or licensed to Zimmer Biomet or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of Zimmer Biomet.