Choosing a graft for femoral bone loss in hip revision
A straight answer from Elite Surgical, hip & knee revision in IU Health, IN.
You pulled the failed stem and now there is a contained femoral defect in your IU Health patient. The void is irregular. You need a graft that packs in, stays put, and does not just sit there as dead filler.
The defect left after stem removal is often a narrow, contained canal with uneven walls. A loose particulate graft can migrate. A stiff block leaves gaps. You need a material that molds into the space, fills all the dead volume, and holds its shape while the bone heals around it.
Cost depends on defect size and graft volume. A small femoral defect may need only 5cc of graft. A larger osteolytic lesion could require 10cc or more. Your hospital’s supply chain team will weigh the per-cc cost against the cost of a second surgery if the graft fails to remodel.
This week, ask your rep to bring a moldable synthetic graft to the OR for your next revision. Look for a silicate-substituted calcium phosphate that packs into the canal with finger pressure, no extra instruments. Elite Surgical can bring ACTIFUSE to your IU Health case and show you the published remodeling data.
After the revision heals, that femoral void is not filled with permanent cement or dead allograft. The scaffold is gone, replaced by the patient’s own living bone across the full defect.
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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.
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Elite Surgical handles hip & knee revision in IU Health and the area around it.