When can I bear weight after tibial plateau fracture with synthetic graft?
Straightforward answers about weight-bearing after fracture repair with synthetic graft, from Cincinnati Children’s, OH.
You're an orthopedic surgeon at Cincinnati Children's. You just repaired a tibial plateau fracture and filled the defect with a synthetic bone graft. Now your patient is asking when they can put weight on the leg. You need a clear postoperative protocol that accounts for the graft material, without guesswork.
Your patient had a tibial plateau fracture. You fixed it with a plate and screws, then packed the bone void with a synthetic calcium phosphate graft like ACTIFUSE. This graft is a scaffold that encourages new bone to grow across the defect. It is not designed to bear weight on its own. That job belongs to the hardware. So the question of when to start weight bearing is not about the graft. It depends on the strength of the fixation and the healing of the fracture itself.
The standard protocol is non-weight-bearing for 8 to 12 weeks. You advance to partial weight bearing once follow-up X-rays show bridging callus and no loss of reduction. The exact timing depends on the fracture pattern, the quality of the bone, and how well the patient follows instructions. The graft does not shorten this timeline. ACTIFUSE remodels over 6 to 12 months, turning into living bone, but early loading risks disrupting the implant-graft interface before integration occurs.
Your job is to follow the fixation protocol, not a graft-specific protocol. Let the patient know that the graft is safe and will eventually be replaced by their own bone. If you have questions about the graft’s remodeling process or want to review the evidence, Elite Surgical can provide in-service support and published clinical data on ACTIFUSE. We cover cases in Cincinnati Children’s and can meet with you or your team to discuss the science behind the graft.
Once the fracture heals, the patient can resume full weight bearing. The graft site will have filled in with new bone, and the hardware will continue to support the joint. The result is a stable, anatomically restored plateau with no residual void. The patient can return to normal activities with confidence.
Other things people in Cincinnati Children’s ask
bone graft for large tibial plateau defect
Pick a graft that resists compression and supports the articular surface. A moldable, high-porosity graft like ALTAPORE SHAPE packs into irregular voids and stays put. For smaller subchondral gaps, a flowable graft delivered by syringe gives complete fill without leaving dead space. Always use it with rigid internal fixation; the graft is not load-bearing on its own.
how to choose bone graft substitute for distal radius fracture
Match the graft form to the void shape. For a small, contained cavity, a flowable graft in a syringe (like ACTIFUSE FLOW) fills every corner without overpacking. For a larger, uncontained defect, a moldable graft (like ACTIFUSE SHAPE) holds its form and does not migrate. If you need antibiotic delivery, ACTIFUSE ABX gives you enhanced handling plus the option to mix in powdered antibiotics. Avoid granules that can scatter into the joint.
cost of bone graft substitute for calcaneus fracture
Calcaneus fractures often need 5cc to 10cc of graft. Price it by volume, not by level. Synthetic grafts like ACTIFUSE are priced per cc. Ask your rep for a per-case cost breakdown that includes the delivery system. Compare that to the cost of a second surgery if the void is left unfilled or collapses.
synthetic bone graft safe open fracture
Synthetic grafts like ACTIFUSE are inorganic and do not provide a food source for bacteria the way allograft can. They can be used in a contaminated field after thorough debridement and irrigation. Many surgeons place the graft at the index procedure to maintain space and deliver local antibiotics mixed into the graft. If there is gross purulence, stage the grafting for a second look 48 to 72 hours later.
ACTIFUSE FLOW vs ACTIFUSE SHAPE fracture
For narrow, deep voids where you need the graft to flow into crevices, use ACTIFUSE FLOW. Its syringe delivery lets you place it precisely without overpacking. For a wide, shallow defect that needs to hold its shape while you close, ACTIFUSE SHAPE molds to the cavity and stays in place. If the void is both deep and wide, start with FLOW to fill the bottom, then cap it with SHAPE.
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Elite Surgical handles fracture repair in Cincinnati Children’s and the area around it.