Combined rotational osteotomy and vascularized iliac bone graft for advanced osteonecrosis of the femoral head.

This paper describes the rationale and technique for a combined procedure of transtrochanteric rotational osteotomy and vascularized iliac bone grafting in cases of osteonecrosis of the femoral head with an extensive and widely collapsed necrotic lesion in young patients. The authors performed this combined operation for 12 joints in 12 patients over 14 years from 1984 until 1997. At a mean of 81 months after the operation, in eight patients who had no pain, the average Harris hip score was 90.