Will a vascularized greater trochanter graft preserve the necrotic femoral head?
GROUND: Various head-preserving procedures have been used for young patients with osteonecrosis of the femoral head (ONFH) to avert the need for THA. However, none of these techniques are accepted universally because of the technical difficulties, complications, or mixed results that often are difficult to reproduce. QUESTIONS/PURPOSES: We describe a technique using vascularized bone grafting for treating ONFH in Stages II-IV (Ficat and Arlet) disease, describe our indications, and report the survival of this technique and the functional scores. METHODS: We retrospectively reviewed 191 patients (195 hips) who underwent vascularized greater trochanter grafting for osteonecrosis of the femoral head (Ficat and Arlet Stages II-IV) from 1995 to 2006. The mean age of the patients was 44 years (range, 19-59 years). The minimum followup was 2 years (mean, 8 years; range, 2-11 years). RESULTS: Twenty patients (23 hips) had conversion surgery to THA. The mean Harris hip scores for the patients w
