Osteonecrosis is a disease characterized by the death of bone cells due to ischemia, which is related to an alteration in blood circulation, resulting in an area of osteomedullary necrosis and located preferentially in the epiphysis of the humeral head, the femoral condyles, the tibial plates and more frequently the femoral head, whose vascularization is particularly precarious. This is a well-defined anatomical and radiological entity, given the large number of studies devoted to it, both diagnostically and radiologically. A distinction is generally made between the most frequent traumatic necroses and non-traumatic necroses associated with certain etiological factors. Biopsy drilling is the most widely used conservative treatment, used alone or in combination with other biological substances, and offers patients with ONTF not only pain relief, but also temporary stabilization of the disease by avoiding early destruction of the coxofemoral joint.