Tibial defect found during knee revision—now what?
A straight answer for surgeons at Ohio State University Wexner Medical Center managing unexpected bone loss behind a failed implant.
You remove the old knee component at Ohio State University Wexner Medical Center. The tibial bone underneath has a contained hole you didn't fully see on the preoperative X-ray. The bone is gone. You need to fill the void, support the revision implant, and avoid a second surgical site for the patient.
A tibial defect sits right under where the failed knee implant used to be. The metal and cement can shield the bone loss on plain films. Once the component comes out, you see the real cavity. It is often a smooth, contained void. You cannot ignore it. The new implant needs a solid foundation. If the defect is left unfilled, the revision can fail.
Filling a contained defect takes about 10 to 15 extra minutes in the OR. The graft cost depends on the volume you need, usually a few cubic centimeters. Using the patient's own bone means a second incision and more pain. Allograft adds donor-site and processing variables. A moldable synthetic graft keeps the surgery to one site. The real cost is the revision failing because the tibial base was not rebuilt.
Pack the defect with a silicate-substituted calcium phosphate graft that has 80 percent porosity. ACTIFUSE shapes into the void and remodels into the patient's own bone as the revision heals. Elite Surgical can bring the graft to your case at Ohio State University Wexner Medical Center and walk your team through the technique. Do not harvest iliac crest if the patient already has enough surgical trauma from the revision itself.
Once the defect is filled and the new implant is seated, the graft integrates over weeks. The tibia remodels. The patient stands on a stable platform. The second surgery never happened.
Other things people in Ohio State University Wexner Medical Center 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 Ohio State University Wexner Medical Center and the area around it.