Is it better to “replace” or “preserve” a collapsed femoral head? The treatment of femoral head necrosis, especially the preservation of the hip joint after collapse (referred to as “hip preservation”), remains one of the most challenging tasks in orthopedics worldwide. A true specialist in femoral head necrosis knows which patients do not need treatment, which patients can be treated non-operatively, and which patients must be operated as soon as possible; which patients can be treated with minimally invasive surgery, and which patients need to be treated with repair and reconstruction of exposed joints; which patients can be deferred for joint replacement, and which patients do not have the value of deferred joint replacement, etc. Secondly, on the basis of knowing the selection, he also mastered the full set of treatment techniques from non-surgical, to minimally invasive surgery, to traditional repair and reconstruction surgery, to artificial joint replacement (from initial to revision). On the question of whether to “replace the joint” or “preserve the joint” after the collapse of femoral head necrosis, it is not possible to make a generalization. The degree, extent and site of collapse are important, but the time of the collapse, the current and future trends of the collapse (symptoms, hip mobility, joint stability, etc.) determine the treatment plan. This means that the patient’s symptoms are more important. A specialist can help you decide whether to “replace” or “preserve” the joint.