In patients with ischemic necrosis of the femoral head, once the femoral head has collapsed (stage III or higher), the osteonecrosis has progressed to an advanced stage, at which point the effectiveness of early head preservation surgery (treatment with decompression implants with support, bone grafting with blood vessels, etc.) is greatly reduced. At this point, if the patient is not obviously symptomatic, the use of the femoral head can be prolonged by reducing weight-bearing walking and taking symptomatic medications. If the patient’s symptoms are significant and cannot be significantly relieved by taking medications, the best course of action may be to undergo an artificial total hip replacement. Modern artificial joint replacement technology has been developed for nearly 50 years since the 1960s. Whether it is the design of the artificial joint prosthesis, materials, processing technology, surgical tools, operating room environment (purified laminar flow room), or the advancement of surgical techniques (depending on the surgeon), all have made qualitative leaps and bounds and have become very mature and reliable, with very positive surgical results. The majority of patients (85%) can last for more than 20 years after total hip replacement surgery. For patients with advanced ischemic necrosis of the femoral head, other conservative treatment methods will not have a fundamental therapeutic effect, and the efficacy of head preservation surgery will be greatly reduced. Regardless of how much money is spent, total hip replacement surgery will eventually be required. Therefore, total hip arthroplasty is probably the most economical and effective treatment method.