Vascularized pedicle iliac bone grafting for osteonecrosis of the femoral head

Osteonecrosis of the femoral head (ONFH) is a debilitating disease and eventually leads to collapse if left untreated. This condition is estimated to account for more than 10 % of the total hip arthroplasties (THAs) performed each year in the United States and more than 50 % in many Asian countries [ 1 – 4 ]. ONFH often affects young active patients and the incidence of bilateral hip involvement is around 50–80 % [ 3, 4 ]. Even though the success rate and the intermediate term of prosthesis survival by using newer bearing surface are improving as compared to the conventional THA, preservation of the femoral head is still the goal in those young active patients.