To The Editor:I read with great interest the article entitled "Influence of
Acetabular Coverage on Hip Survival After Free Vascularized Fibular Grafting
for Femoral Head Osteonecrosis," (2006;88:2152-8), by Roush et al., and
the commentary by Steinberg and Steinberg1. Indeed, this article
and the commentary by Marvin Steinberg1 represent the views and
thoughts of two senior authors with opposing opinions on how to treat
osteonecrosis. Urbaniak2 supports vascularized bone-grafting,
whereas Steinberg3 supports avascular cancellous bone-grafting.
While the intent of the article by Roush et al. was not to document the
clinical efficacy of either type of bone-grafting, the conclusions made
therein invariably influence one's ability to recognize a potential limitation
of free vascularized fibular grafting, and it is from this observation that I
would like to offer a few comments.