Tibial defect found during knee revision: now what?
Hip & knee revision in IU Health, IN: what to do when a tibial defect appears after implant removal.
You take out a failed knee implant in IU Health, IN and find a contained tibial defect the X-ray did not show. The hole under the old component needs a graft that packs the void, supports the new implant, and does not add a harvest site. Autograft would mean a second incision, which this patient does not need.
During a knee revision, the tibial bone under a failed component often has a contained defect. It is a hole or hollow that the old implant hid. X-rays do not show the full bone loss because the metal blocks the view. In IU Health, IN, this shows up most often after a knee replacement has been in place for ten years or more. The defect is walled off, so it can be packed without changing the rest of the procedure.
Packing a contained tibial defect is a short step, not a separate operation. The graft is pressed into the void by hand, so it adds minutes to the revision. The main cost driver is the amount of graft material needed, which depends on defect size. Avoiding autograft also saves the time and expense of a second incision in the iliac crest or tibia. You are not adding a second recovery site.
This week, call Elite Surgical to have ACTIFUSE or ALTAPORE in the room before the next knee revision. Ask for a graft that is 80% porous and remodels into host bone as the revision heals. Do not default to autograft if the patient already has a second surgical site. Cover the case now so the graft is on the shelf and the defect gets packed without delay. The representative can walk your team through the published clinical evidence before the day of surgery.
Once the defect is packed, the new knee component sits on stable bone. Over time, the graft remodels into the patient's own bone. The revision heals with one incision, not two. The patient gets back to walking without a harvest site to manage. You have a contained defect handled, not a surprise.
Other things people in IU Health ask
bone graft for tibial bone loss revision knee
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.
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.
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.
synthetic bone graft safe infected revision
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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Elite Surgical handles hip & knee revision in IU Health and the area around it.