Ninety percent of the osteonecrosis we see clinically is associated with hormone use and alcohol abuse. However, some of the same people who use hormones and alcohol do not develop osteonecrosis. In the population we investigated, some people used nearly 30,000 mg of methylprednisolone without osteonecrosis, while others used only 175 mg and developed multiple joint necrosis. Some people with lifelong alcohol abuse did not develop osteonecrosis; conversely, a few people who consumed only small amounts of alcohol developed osteonecrosis. The pathogenesis of non-traumatic osteonecrosis is still not very clear, and the theory of intravascular coagulation has been more researched at home and abroad in recent years. 1992, American scholar Jones formally proposed the theory of intravascular coagulation in non-traumatic osteonecrosis, and he kept improving it in the subsequent research. He believed that intravascular coagulation, an intermediate mechanism, is most likely to be the final common pathway for the development of osteonecrosis. Patients who develop osteonecrosis often have abnormal indicators and genetic variants of hypercoagulable and hypofibrinolytic tendencies, while others who use a lot of hormones or alcohol but do not have osteonecrosis tend to have normal indicators of these. Therefore, the occurrence of osteonecrosis can be predicted by testing these indicators and genes in populations requiring hormone use or alcohol abuse. Our study of a large number of cases showed that the occurrence of osteonecrosis in the national population is associated with a number of hypercoagulable and hypofibrillar factors in the blood such as protein C (PC), activated protein C resistance (APC-R), fibrinogen activator inhibitor (PAI), and genes associated with them. The incidence of testing abnormalities in the osteonecrosis population is more than 85%, so the detection of these factors and genes can predict the national population at high risk for osteonecrosis. In clinical practice, screening for these factors and genes in people who must use corticosteroids during the treatment of diseases such as nephritis, organ transplantation and systemic lupus erythematosus, as well as alcohol abuse, and screening for high-risk groups and applying pharmacological interventions to high-risk groups while using hormones will reduce the occurrence of osteonecrosis. In addition, once osteonecrosis has occurred, these tests will clarify the cause and the use of anticoagulant and pro-fibrinolytic drugs will correct the patient’s blood status before irreversible collapse occurs in the early stages of osteonecrosis, thus interrupting or even reversing the course of the disease and avoiding surgical treatment and disability.