Among the many treatment options for preserving the joint in femoral head necrosis, medullary core decompression has the longest history and proven efficacy. Based on this, our department has developed various minimally invasive joint preservation surgery plans according to the stage and characteristics of each patient’s femoral head necrosis by combining the advantages and disadvantages of traditional medullary decompression, with the aim of enabling patients to preserve their own joints and avoid artificial joint replacement or delay artificial joint replacement as much as possible. The following surgical procedures are minimally invasive (1) Multi-portal fine needle (2.5mm or 3.2mm) core decompression (2) Large diameter (10 or 12mm) core decompression (3) Single portal large diameter core decompression + multi-portal fine needle core decompression (4) Single portal large diameter core decompression + special reamer to remove necrotic foci + autologous bone compression Bone grafting (5) Single orifice large diameter medullary core decompression + special reamer to remove necrotic foci + homograft bone or artificial bone compression Bone grafting technology features: the special reamer is the latest patented product, which can remove the necrotic foci to the largest extent under minimally invasive conditions, the surgical incision is only about 3cm, and the decompression range is more complete than traditional decompression techniques; homograft bone or artificial bone can avoid damage to the donor area during autologous bone grafting. (6) Single orifice large diameter marrow core decompression + special reamer to remove necrotic foci + allograft bone or artificial bone compression bone grafting + growth factor Technical features: special reamer is the latest patented product, which can remove necrotic foci to the largest extent under minimally invasive conditions, the surgical incision is only about 3cm, and the decompression range is more complete than traditional decompression techniques; allograft bone or artificial bone can avoid donor area damage during autologous bone grafting The compound growth factor can promote the speed of bone healing in the bone graft.