Bone graft not remodeling on follow-up CT?
Honest answers from Elite Surgical, foot & ankle fusion in Bon Secours Mercy Health, OH.
You're a foot and ankle surgeon at Bon Secours Mercy Health. Your fusion patient is six months post-op. The CT shows the graft material sitting there, not looking like host bone. You're worried about a nonunion.
Not all bone graft substitutes remodel the same way. Some are designed to be replaced by bone quickly. Others linger. If your graft lacks an interconnected pore structure, new bone can't grow through it. The result: a CT that looks like the graft never changed. A silicate-substituted calcium phosphate scaffold, like the one in ACTIFUSE, has interconnected pores. These pores allow bone to grow through and replace the graft over time.
If the graft isn't remodeling, you might need a revision. That means another surgery, more recovery time, and potential harvest site pain if you switch to autograft. A revision fusion can take months of healing. Choosing a graft with proven resorption up front avoids this. It saves the patient a second procedure and the risks of iliac crest harvest.
This week, pull the graft's resorption profile. Look for published CT evidence in foot and ankle fusions. Ask your rep for the 24-patient tibiotalar series data using SiCaP. Elite Surgical can provide the full ACTIFUSE clinical dossier. Bring it to your next value analysis meeting to compare against other synthetics. Make sure your graft has predictable remodeling before the next case.
Your next fusion patient gets a graft that remodels into real bone on schedule. Follow-up CT shows trabecular bridging, not a static void. No second surgery, no iliac crest harvest, just a solid fusion. You can trust the graft to do its job, so you can focus on the reconstruction.
Other things people in Bon Secours Mercy Health 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.
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Elite Surgical handles foot & ankle fusion in Bon Secours Mercy Health and the area around it.