Approximately 10,000 to 20,000 new patients are affected by osteonecrosis of the femoral head (ONFH) each year in the United States. Although many joint-preserving procedures are available to treat ONFH, free vascularized fibular grafts (FVFG) can be an appropriate strategy for select patients to relieve pain, preserve or restore the femoral head, and delay the need for total hip arthroplasty. Review factors to consider, including disease stage, etiology, lesion size and location, and the presence of comorbidities, to help determine the most appropriate intervention for individual patients with ONFH.
Marc J. Richard, MD
Orthopaedic Surgeon
Duke University Medical Center
Durham, NC
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