How to choose a bone graft substitute for a large acetabular defect in revision hip
Straight answers for surgeons in Allegheny Health Network, PA dealing with contained acetabular bone loss.
You have a failed hip on the table. The acetabulum has a large contained defect. You need a graft that fills the void, supports the cup, and becomes host bone. In Allegheny Health Network, you want a graft that packs well and remodels predictably.
A large contained acetabular defect means the socket side of the hip has lost bone inside its rim. The defect is contained, so the walls are intact. You need a graft that fills that space completely. It must give early support to the revision cup. Over time, it should turn into the patient's own bone. A graft that resorbs too fast can leave the cup loose. A graft that never remodels stays as a permanent foreign block. The goal is a scaffold that encourages bone to grow through it.
The cost here is not just the price of the graft. It is the cost of a second revision if the graft fails. Time in the OR matters too. A graft that is hard to pack into an irregular defect adds minutes. A graft that comes in a moldable form can speed things up. The size of the defect drives how much graft you need. Larger defects need more volume. The shape matters. A contained defect with smooth walls is easier to fill than one with deep pockets.
This week, when you plan the revision, choose a graft with high porosity. ACTIFUSE has an 80% porous structure. It is a silicate-substituted calcium phosphate. It packs into contained defects well. It remodels into host bone as the revision heals. For very large or irregular defects, consider ACTIFUSE SHAPE. It is moldable to fit the contours. Avoid grafts that are too dense for bone to grow through. Avoid grafts that resorb before the cup gets biologic fixation. If you need product in the OR, contact Elite Surgical for case coverage in Allegheny Health Network.
Once the graft is in and the cup is stable, the defect starts to fill with new bone. The construct gains strength over weeks and months. The patient gets a hip that is supported by their own bone, not just cement and metal. You avoid the worry of a loose cup down the line. The revision has a better chance to last.
Other things people in Allegheny Health Network ask
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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.
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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.
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Choose a moldable synthetic bone graft substitute for irregular femoral defects. It should pack into the canal without extra instruments. Look for a graft that remodels into host bone so the area is not left with permanent filler.
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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.
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Ask for per-cc or pack pricing, not a flat case price. Cost depends on the size of the acetabular or femoral defect. Compare synthetic graft cost to autograft, which includes OR time and a second incision.
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Elite Surgical handles hip & knee revision in Allegheny Health Network and the area around it.