Bone graft not remodeling on follow-up CT
For University Hospitals Cleveland surgeons managing foot & ankle fusion: a graft that becomes real bone without a second harvest site.
You are six months out from a tibiotalar or subtalar fusion in University Hospitals Cleveland. The CT shows the graft sitting there, but it does not look like host bone. You are watching for a nonunion and your patient is asking questions.
Not all synthetic grafts remodel at the same rate. Some are just fillers that sit in the gap. A graft with a highly porous, interconnected scaffold is built to be replaced by host bone over time. If the scaffold pores are too small or closed off, cells cannot get in and the graft stays inert on follow-up imaging.
A revision fusion costs time, money, and trust. You may need to work up a nonunion, plan hardware revision, and open a second site for autograft. The case gets bigger. A graft that remodels predictably from the start keeps the first surgery the only surgery.
Check your graft's resorption profile. ACTIFUSE and ALTAPORE use a silicate-substituted calcium phosphate scaffold with interconnected pores that allow bone to grow through and replace the graft. Published foot and ankle data includes a 24-patient tibiotalar series. Elite Surgical brings this graft into University Hospitals Cleveland and covers your cases with in-service support.
Six months later, the CT shows a fusion mass that looks like real bone. The graft is gone, replaced by the patient's own tissue. Your patient walks without the limp, and you close the chart without scheduling a revision.
Other things people in University Hospitals Cleveland ask
weight bearing after ankle fusion with synthetic bone graft
Weight bearing depends on fixation stability, not just the graft. With ACTIFUSE, the scaffold starts remodeling within weeks, but full load is typically allowed after 6-8 weeks if the construct is solid. Check your specific fixation and follow published protocols for tibiotalar fusion with this graft.
ACTIFUSE FLOW vs ACTIFUSE SHAPE ankle fusion
FLOW is ideal for narrow, irregular spaces because the syringe lets you inject it precisely. SHAPE is better when you need to pack a larger void and want the graft to stay in place without migrating. For a typical ankle fusion with moderate bone loss, either can work. Choose FLOW if you need to fill a tight gap; choose SHAPE if you need to build up a defect and contour it.
bone graft substitute for diabetic ankle fusion
Use a scaffold that remodels into real bone and can handle poor host biology. ACTIFUSE provides an 80% porous structure that the body replaces with living bone, without harvesting from the hip or heel. Published tibiotalar fusion series using this graft show reliable outcomes in compromised patients.
cost of bone graft substitute for ankle fusion
The price depends on the volume of graft needed and the specific product. For a standard ankle fusion, a synthetic graft like ACTIFUSE typically costs less than using a bone graft harvested from the patient when you factor in OR time and donor site complications. Get a quote from your supplier for the exact product and volume.
normal shoes after ankle fusion synthetic bone graft
Most patients can transition to a supportive shoe around 10 to 12 weeks after surgery, once X-rays show the fusion is solid. Synthetic grafts like ACTIFUSE remodel into real bone, so the timeline is similar to autograft. Always confirm healing on imaging before clearing the patient.
Ready to talk?
Elite Surgical handles foot & ankle fusion in University Hospitals Cleveland and the area around it.