The descending branch of the lateral circumflex femoral artery: a reliable and robust alternative blood supply in the free fibular transfer for avascular necrosis of hip

Abstract

Avascular necrosis (AVN) of the femoral head is a disastrous condition and even more tragic when affecting the young adult. The fact that AVN has a number of aetiological trigger conditions underpins the fact that ultimately there is loss of vascularity to the caput. Early aggressive treatment through core decompression and vascularised bone grafting has been shown to successfully arrest disease progression. We describe here in a patient series the descending branch of the lateral circumflex femoral artery and vein as reliable alternative vascular recipient vessels to convention for receiving the bone flap. Further refinements are described to expedite the procedure and promote success. It is believed that this is the first described experience of this technique for AVN of the hip.