Bone graft not remodeling on your ankle fusion CT?
Honest answers from Elite Surgical for foot & ankle fusion patients in Cincinnati Children's, OH.
You’re a Cincinnati Children’s surgeon. A patient’s tibiotalar or subtalar fusion CT at six months shows the bone graft substitute sitting there. It hasn’t remodeled into real bone. You see a radiolucent line or a gap. You know this could mean a nonunion if the graft never integrates. You need a graft that reliably turns into living bone on follow-up imaging.
When a bone graft substitute doesn't remodel, the CT often shows persistent graft granules. Some synthetics resorb very slowly or not at all. The body doesn't recognize the material as bone, so it sits there. With a graft like ACTIFUSE, the silicate-substituted calcium phosphate creates a scaffold that mimics natural bone mineral. Its interconnected pores let blood vessels and bone cells invade. Over months, your patient's own bone replaces the scaffold, leaving living bone behind. That's what you don't see on your current CT.
The real cost isn't the graft alone. It's the lost OR time if you have to revise a nonunion. A failed fusion means another surgery, more implants, and a longer recovery for the patient. The patient may lose trust in the outcome. While no graft guarantees success, a graft with published remodeling data for foot and ankle fusion can lower the odds of a poor CT. ACTIFUSE costs are in line with other synthetics, but skipping a revision is where the savings add up. Over time, predictable bone integration saves the system money.
Call Elite Surgical for published fusion data. We can walk you through the 24-patient tibiotalar series and other evidence. Ask your product rep for the resorption profile of the graft you're using now. If it doesn't show predictable remodeling on CT, switch to ACTIFUSE or ALTAPORE for your next ankle or hindfoot fusion. The rep can also arrange a product demo for your OR staff.
Your next CT shows trabecular bone crossing the fusion site. The graft is gone, replaced by solid, living bone. The radiolucent line is filled in. You clear the patient for full weightbearing. No second surgery. The fusion is complete.
Other things people in Cincinnati Children’s ask
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.
ACTIFUSE FLOW vs ACTIFUSE SHAPE ankle fusion
FLOW is ideal for narrow, irregular spaces because the syringe lets you inject it precisely. SHAPE is better when you need to pack a larger void and want the graft to stay in place without migrating. For a typical ankle fusion with moderate bone loss, either can work. Choose FLOW if you need to fill a tight gap; choose SHAPE if you need to build up a defect and contour it.
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.
Ready to talk?
Elite Surgical handles foot & ankle fusion in Cincinnati Children’s and the area around it.