Introduction: We present our experience in the treatment of the aseptic necrosis of the femoral head with a vascularized iliac crest graft by means of a retrospective analysis of 25 hips (22 patients) subjected to surgery in our hospital between June 1993 and September 2002.

Materials and methods: There was a predominance of male patients (20 cases). In most patients the necrosis appeared in the left side. The most common predisposing factor was alcohol abuse (8 cases). All patients were subjected to a clinical (Harris score) and a radiological evaluation, and the evolution of their necrosis was assessed using the Ficat-Arlet system (as modified by ARCO) with a mean follow-up of 4 years.

Results: The average functional evaluation was of 87 points, with 76% of results in the excellent and good categories and 24% fair and poor. 40% of the hips underwent some kind of radiological deterioration (mean: 5.2 years). On the basis of the radiological evaluation criteria, 66% of patients evolved satisfactorily.

Conclusions: Our results are in line with those published in the literature. 60% of patients operated on showed no evidence of a radiological progression of the necrosis of the femoral head.