Tibial bone loss behind your failed knee replacement?
Honest answers from hip & knee revision specialists serving IU Health, IN.
A failed knee replacement in the IU Health system often reveals a contained defect in the tibia. You see bone loss right behind that old baseplate. The void needs packing, not just cement, to give the new implant a solid foundation. Leaving it empty risks early loosening.
Tibial bone loss happens when a knee replacement loosens over time. Particles from the worn implant cause the body to resorb bone. You're not alone. This is a common finding in failed knee replacements. On X-ray, you'll see a dark area beneath the baseplate. That's a contained hole that must be filled before the revision. If you cement over it without a scaffold, the new joint will loosen again.
The scope depends on the defect's size. A contained tibial defect may need 5cc to 15cc of graft material. Using a synthetic scaffold avoids a second incision for autograft harvest, saving 30 minutes of surgery. The graft's cost is a fraction of a re-revision, which can run five figures. Your hospital's value analysis team negotiates pricing, but a typical case uses a few hundred dollars of graft. Compared to BMP-2, synthetic grafts have a much lower list price. The real cost is leaving the void unfilled.
Call Elite Surgical to have ACTIFUSE in your tray for the next revision. Their team covers cases in the OR and in-services your staff on the graft. ACTIFUSE is a porous synthetic scaffold that packs contained defects, holds shape, and remodels into the patient's own bone. Contact Elite Surgical at least a week before the case. They'll ensure ACTIFUSE is on the shelf and your team knows how to use it. Ask your OR manager to stock it. Don't leave the defect empty or fill it with cement alone.
You open the revision, pack the defect, and seat the new implant with confidence. The graft remodels as the patient heals, replacing the void with living bone. No loose cement pillar, no dark zone on follow-up X-rays. Follow-up images show dense bone, not cement. The patient gets a stable knee that can last. That's the difference a scaffold makes.
Other things people in IU Health ask
bone graft for tibial defect during knee revision
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.
bone graft substitute for large acetabular defect revision hip
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.
how to choose bone graft substitute for femoral defect revision hip
Choose a moldable synthetic bone graft substitute for irregular femoral defects. It should pack into the canal without extra instruments. Look for a graft that remodels into host bone so the area is not left with permanent filler.
how to choose bone graft femoral defect revision hip
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.
bone graft substitute cost revision hip
Ask for per-cc or pack pricing, not a flat case price. Cost depends on the size of the acetabular or femoral defect. Compare synthetic graft cost to autograft, which includes OR time and a second incision.
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Elite Surgical handles hip & knee revision in IU Health and the area around it.