A combined operation of transtrochanteric osteotomy and vascularized iliac bone graft for advanced osteonecrosis of the femoral head

Since 1984, we have performed a combined operation of transtrochanteric rotational ostcotomy and vascularizcd iliac bone grafting for advanced osteonecrosis of the femoral head with an extensive necrotic lesion involving more than 2/3 of the femoral head in lateral x-ray. The criteria for this procedure were an age of less than forty-five years, Ficat stage-III and stage-IV osteonecrosis of the femoral head. At a mean of eighty-one months after operation, eight patients had clinically satisfactory results and ten hips were protected from further collapse of the femoral head. This procedure was successful in restoring congruity of the femoral head and we recommend this for advanced and extensive osteonecrosis of the femoral head.