Choosing a graft for femoral bone loss in hip revision
Practical guidance for surgeons in Cincinnati Children’s, OH, from Elite Surgical, hip & knee revision specialists.
You removed the failed stem and now face an irregular, contained femoral defect. The canal needs a graft that fills dead space, holds shape, and does not leave permanent filler. In Cincinnati Children’s, having a reliable option matters for every revision case.
Identify the problem first. Stem removal often leaves a femoral defect that is uneven and hard to reach. Standard chips or putty can migrate or fail to pack tightly. You need a material that conforms to the canal walls and stays put during closure.
Cost and scope depend on defect size and graft volume. A contained defect may require 5cc to 10cc of graft. No extra mixing tools or special instruments are needed. This keeps prep time short and reduces waste. The real cost is in revisions that fail because the graft did not remodel.
What to do this week. Select a moldable synthetic graft that packs into the canal without force. Look for a silicate-substituted calcium phosphate that remodels into host bone over time. Elite Surgical provides ACTIFUSE, which has an 80% porous scaffold for this exact purpose. Ask for a case coverage or in-service to see how it handles in your hands.
Once the defect is filled and the revision heals, the graft becomes the patient’s own bone. No permanent filler remains. The canal is restored, and the new implant has solid support. The worry about dead space is gone.
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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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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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Elite Surgical handles hip & knee revision in Cincinnati Children’s and the area around it.