Femoral Head Vascularity and Notching of the Femoral Neck during Surfacearthroplasty of the Hip

Introduction In adults, the greatest portion of the blood supply to the femoral head is derived from extraosseous vessels on the posterior lateral surface of the femoral neck with the main supply coming from a branch of the medial circumflex artery(Fig 1). When performing intra-articular procedures in non-arthritic hips, surgeons advocate surgical approaches and techniques to avoid damage to the extraosseous blood supply and the subsequent onset of osteonecrosis. In the arthritic femoral head, the blood supply to the femoral head may involve some combination of intraosseous and extraosseous sources, making unclear the role of the retinacular vessels (extraosseous) in the femoral head blood supply.