Prospective cohort study of 103 consecutive hips in 89 patients treated with free vascularized fibular grafting (FVFG) for symptomatic femoral head osteonecrosis, staged by the Marcus classification, with minimum 5-year follow-up. The study asks whether FVFG preserves the native hip and improves function across all disease stages, including after subchondral collapse.
When a patient under 50 presents with symptomatic femoral head osteonecrosis — particularly stage II or III before extensive subchondral collapse.
FVFG is a joint-preserving option with only 11–23% THA conversion at 5 years, buying meaningful functional time before arthroplasty and leaving THA technically straightforward if ultimately required.
Even stage IV–V disease shows significant Harris hip score gains, so the procedure remains worth discussing in younger patients who are not yet ready for arthroplasty.
Prospective cohort study of 103 consecutive hips in 89 patients treated with free vascularized fibular grafting (FVFG) for symptomatic femoral head osteonecrosis, staged by the Marcus classification, with minimum 5-year follow-up. The study asks whether FVFG preserves the native hip and improves function across all disease stages, including after subchondral collapse.
When a patient under 50 presents with symptomatic femoral head osteonecrosis — particularly stage II or III before extensive subchondral collapse.
FVFG is a joint-preserving option with only 11–23% THA conversion at 5 years, buying meaningful functional time before arthroplasty and leaving THA technically straightforward if ultimately required.
Even stage IV–V disease shows significant Harris hip score gains, so the procedure remains worth discussing in younger patients who are not yet ready for arthroplasty.