Avascular necrosis of the femoral head: role of vascularized bone grafts.

This article presents the history and development of as well as the results from the various techniques of vascularized bone grafting for the treatment of osteonecrosis (ON) of the femoral head. The authors have treated more than 2600 patients who had femoral head ON, using a vascularized fibular graft by way of an intraosseous approach. The results from this vast experience are summarized and certain pearls and pitfalls regarding the treatment of femoral head ON using the free vascularized fibular graft are highlighted.