Tibial bone loss behind a failed knee replacement?
Hip and knee revision for tibial bone loss behind a failed knee replacement in University Hospitals Cleveland, OH.
You are in University Hospitals Cleveland, looking at a revision knee where the old baseplate has come loose. Underneath, there is a pocket of missing bone in the top of the tibia. That empty space has to be filled before the new implant goes in. The new part cannot sit on a void.
When you open a failed knee replacement, you may see a hollow pocket in the top of the shin bone. That is tibial bone loss behind the old baseplate. It happens when a loose implant grinds away bone over months or years. The defect is often contained, meaning there are walls of bone around the hole. You see this on the pre-op CT or the moment the implant comes out. If you leave that pocket unfilled, the new baseplate sits on a void and can loosen early.
Filling the void adds a step to the revision. It usually takes ten to twenty extra minutes in the OR. The graft cost depends on the size of the tibial defect. A small contained pocket needs less material. A larger defect may need more graft, or an augment, or a longer stem. Having the right scaffold on the table means the case does not stall while someone calls around for bone.
Do not leave that tibial pocket empty. Do not fill it with cement alone. Cement fills space but does not turn into living bone. Pack the defect with a porous synthetic bone graft scaffold. It should hold its shape and remodel into the patient's own bone as the knee heals. Elite Surgical can be at your University Hospitals Cleveland case with ACTIFUSE, the published evidence, and an in-service for your team.
Afterwards, the pocket is no longer empty. The new baseplate sits on a scaffold that is slowly becoming the patient's own bone. The revision knee has a stable foundation, and the patient can start moving with less risk of early loosening. That is the outcome you want before you close. Then the patient goes to recovery with a stronger foundation.
Other things people in University Hospitals Cleveland 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 University Hospitals Cleveland and the area around it.