Is synthetic bone graft safe in infected revision?
For hip & knee revision at University Hospitals Cleveland, OH: what the graft evidence says.
You're revising an infected total knee at University Hospitals Cleveland. The tibial component has come out and left a void in the bone. You don't want to place a graft that turns into a hiding spot for bacteria. You need to know if a synthetic option is safe in a potentially contaminated field.
When a knee replacement gets infected, the bone around the implant can weaken. Removing the infected component leaves a defect, often behind the tibial tray. Old bone chips and structural allografts can act as a sequestrum, a dead piece of bone that bacteria hide in. In a contaminated field, that dead bone gives the infection a place to survive. That is what makes you hesitate about filling the void during a revision.
An infected revision is usually two operations, not one. First, the implant comes out and an antibiotic spacer goes in. Weeks of IV antibiotics follow, often through a PICC line at home. Then a new knee goes in, and the bone void gets filled with graft. The graft itself is a small line item compared with the cost of two hospital stays and two surgeries. The graft choice changes operative time by minutes, not hours, so it does not drive the overall cost.
This week, do not use a structural allograft in a potentially contaminated field. A porous synthetic scaffold like ACTIFUSE has an 80% open structure. New blood vessels grow into it. Antibiotics reach it. It slowly remodels into the patient's own bone over the next year. Use it as part of a staged protocol with local antibiotics at the time of reimplantation. Elite Surgical can bring ACTIFUSE to your University Hospitals Cleveland OR and walk your team through the technique.
Once the void is packed with a scaffold that allows blood flow, the two-stage revision has a better chance to clear the infection. The graft remodels into living bone over the following months. There is no dead piece left behind to hide bacteria. You close the knee knowing the fill will become part of the patient's own skeleton.
Other things people in University Hospitals Cleveland 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.
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.
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.
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.
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Elite Surgical handles hip & knee revision in University Hospitals Cleveland and the area around it.