Choosing a graft for femoral bone loss in hip revision
How a moldable synthetic option helps Bon Secours Mercy Health, OH surgeons fill irregular defects and remodel host bone.
You are revising a hip in Bon Secours Mercy Health. Stem removal left an irregular, contained femoral defect. You need a graft that packs dead space, holds shape, and does not leave permanent filler. That exact problem has a direct answer.
Identify When a hip stem comes out, it often leaves behind a void in the thigh bone. The defect is irregular, contained, and unpredictable. You cannot cut a block of bone to fit it. You need a material that flows into the space and stays put. A rigid graft will leave gaps. A loose particulate can migrate. The goal is to fill all of the dead space and support the new stem.
Cost / scope The graft choice depends on defect size, patient health, and facility contract pricing. Synthetic moldable grafts fall between basic allograft and premium biologics. A typical femoral defect uses 5 to 15 cc of product. Each cc costs roughly as much as a decent dinner for two, but the total number hinges on your facility's supply chain. Preoperative CT helps you estimate volume so you do not order too much or too little.
Action Call Elite Surgical and ask to trial a silicate-substituted calcium phosphate that packs into the canal without extra instruments. Your goal is a graft that remodels into host bone over time so the site is not permanently filled with foreign material. The team will bring ACTIFUSE and ALTAPORE to your case, in-service your staff in Bon Secours Mercy Health, and walk you through the published remodeling data. Try it on a contained femoral defect where irregular geometry makes traditional blocks or chips a poor fit.
End-state The femoral defect is fully packed. The graft holds its shape while the new stem is seated. Over months, the material remodels into the patient's own bone. The revision heals without a permanent filler left behind. Your patient bears weight on living bone, and the canal looks clean on the next follow-up radiograph.
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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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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.
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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.
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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.
Ready to talk?
Elite Surgical handles hip & knee revision in Bon Secours Mercy Health and the area around it.