Nonunion of the femoral neck and avascular necrosis of the femoral head: treatment with bone grafts.

The use of full-thickness iliac bone grafts shaped into cigar and cigarette forms in the treatment of nonunion of the femoral neck and idiopathic avascular necrosis of the femoral head was studied. Results of 36 operations (18 hips in each category) were classified according to pain, range of motion, function, and roentgenographic appearance. Follow-up with a two-year minimum revealed that bone grafting contributed to a successful result in the nonunion group with 17 hips uniting. Thirteen hips with avascular necrosis, however, showed progression of disease and were classified as failures. In light of these results, bone grafting in the treatment of idiopathic avascular necrosis must be questioned.