[Free autologous iliac graft in femoral head osteonecrosis]

Failures of hip arthroplasties in younger patients led us to choose, in Steinberg III and IV stages, a resection of the necrosis and a "filling in" with a free autologous cancellous iliac graft. Indications for an iliac graft are the necrosis at Steinberg III and IV stages, with a Kerboull angle inferior to 180 degrees, a necrotic depth inferior to 1.5 cm, in patients under 55. Its advantages allow to avoid the microsurgical techniques of vascularized grafts and the complications of a possible secondary arthroplasty, as it sometimes occurs after an osteotomy. The long period of non-weightbearing after the graft is a relative inconvenient well tolerated by younger patients. However, the number of cases is still not sufficient to be statistically significant. Good results are maintained after 6 to 15 years.