ACTIFUSE FLOW vs. SHAPE for ankle fusion — which fills the gap better?
Straight talk on graft handling and fusion for foot and ankle cases at Cincinnati Children’s, OH.
You’re in the OR at Cincinnati Children’s, prepping for a tibiotalar or subtalar fusion. The defect is open in front of you, and both ACTIFUSE FLOW and SHAPE are on the shelf. You need to know which one gives you better control and a solid fusion for this specific space.
FLOW is loaded in a syringe. It injects precisely into narrow, irregular voids. The paste fills the gaps without air pockets and sets quickly once it contacts body fluid. If your defect is a tight crevice or a hard-to-reach fusion site, FLOW puts the graft right where you want it.
SHAPE comes as a moldable strip. You can pack it into a larger void, contour it to the anatomy, and it stays put. It resists migration even before hardening. Use SHAPE when you need to build up a defect that has lost some structural contour, like a collapsed midfoot joint or a cystic cavity in the talus.
For a typical ankle fusion with moderate bone loss, either product works. The decision turns on defect geometry. If you want to see published data, Elite Surgical can share a 24-patient tibiotalar series using silicate-substituted calcium phosphate. Call us before your next case. We will review your imaging with you and help you pick the right graft.
After surgery, the ACTIFUSE scaffold is gradually replaced by the patient’s own bone. The fusion site becomes solid, living bone without a second harvest site. Your patient heals with less pain, and you avoid the complications of iliac crest graft.
Other things people in Cincinnati Children’s ask
bone graft substitute not remodeling
Not all synthetics remodel at the same rate. A graft with a highly porous, interconnected scaffold, like ACTIFUSE or ALTAPORE, is built to be replaced by host bone over time. Check your graft's resorption profile. If you need predictable remodeling, choose one with published fusion data for foot and ankle.
weight bearing after ankle fusion with synthetic bone graft
Weight bearing depends on fixation stability, not just the graft. With ACTIFUSE, the scaffold starts remodeling within weeks, but full load is typically allowed after 6-8 weeks if the construct is solid. Check your specific fixation and follow published protocols for tibiotalar fusion with this graft.
bone graft substitute for diabetic ankle fusion
Use a scaffold that remodels into real bone and can handle poor host biology. ACTIFUSE provides an 80% porous structure that the body replaces with living bone, without harvesting from the hip or heel. Published tibiotalar fusion series using this graft show reliable outcomes in compromised patients.
cost of bone graft substitute for ankle fusion
The price depends on the volume of graft needed and the specific product. For a standard ankle fusion, a synthetic graft like ACTIFUSE typically costs less than using a bone graft harvested from the patient when you factor in OR time and donor site complications. Get a quote from your supplier for the exact product and volume.
normal shoes after ankle fusion synthetic bone graft
Most patients can transition to a supportive shoe around 10 to 12 weeks after surgery, once X-rays show the fusion is solid. Synthetic grafts like ACTIFUSE remodel into real bone, so the timeline is similar to autograft. Always confirm healing on imaging before clearing the patient.
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Elite Surgical handles foot & ankle fusion in Cincinnati Children’s and the area around it.