Femoral defect after stem removal: which graft holds its shape?
A practical answer for hip & knee revision surgeons at Allegheny Health Network, PA, from Elite Surgical.
At your Allegheny Health Network OR, you've just removed a failed stem. The femoral defect is irregular and contained. You need a graft that fills the void without extra instruments and remodels into host bone over time.
When a stem is removed, the proximal femur often has a cavitary defect. The bone walls are intact, but the space inside needs a scaffold. Without it, the void may fill with fibrous tissue, or a loose graft can migrate. You need a material that is moldable, stays in place, and stimulates new bone. A silicate-substituted calcium phosphate graft like ACTIFUSE is designed for this job.
Choosing a synthetic graft saves the patient a second surgical site for autograft. It also avoids the supply constraints and variability of allograft. The graft comes in a pre-filled syringe, so it packs into the canal in seconds. No mixing, no special tools. The price per case is predictable, and the reduced complication risk can offset the implant cost. Your value analysis committee will want to see the remodeling data.
Before your next hip revision, call Elite Surgical to schedule a case. They will bring ACTIFUSE to your Allegheny Health Network facility and walk your staff through the technique. They can also present the clinical evidence for remodeling to your committee. That way, you have the graft and the data ready when the patient is on the table.
After the case, the femoral defect is filled with a porous scaffold. Over months, radiographs show the graft being replaced by host bone. The canal is solid, and there is no permanent filler left behind. The patient heals with a strong construct.
Other things people in Allegheny Health Network ask
bone graft for tibial bone loss revision knee
Pack the contained defect with a porous synthetic bone graft scaffold. It should hold shape and remodel as the revision heals. Do not leave the defect empty or filled with cement alone.
bone graft for tibial defect during knee revision
Pack the contained defect with a moldable bone graft substitute that has high porosity and remodels into host bone. Avoid autograft if the patient already has a second surgical site. The graft should support the new implant while healing.
bone graft substitute for large acetabular defect revision hip
Pick a graft that packs the defect well and has high porosity for bone ingrowth. ACTIFUSE's 80% porous scaffold fills contained defects and remodels into the patient's own bone as the revision heals. For very large defects, consider a moldable version like ACTIFUSE SHAPE to adapt to irregular contours. Avoid grafts that resorb too fast and leave the cup unsupported.
synthetic bone graft safe infected revision
You need a graft that won't act as a sequestrum. Porous synthetic scaffolds like ACTIFUSE allow vascular ingrowth and antibiotic penetration. They don't provide a hiding place for bacteria the way a structural allograft can. Use it with a staged protocol and appropriate local antibiotics.
how to choose bone graft femoral defect revision hip
Look for a porous scaffold that holds shape when packed and remodels over time. Match the graft format to the defect. A runny material will not stay in an open femoral defect.
Ready to talk?
Elite Surgical handles hip & knee revision in Allegheny Health Network and the area around it.