Ischemic necrosis of the femoral head usually occurs in patients under 40 years of age, and 12% of patients undergoing total hip replacement are due to ischemic necrosis of the femoral head. Corticosteroids, smoking and alcohol consumption, and hemoglobinopathies are risk factors for osteonecrosis. For early stage of femoral head necrosis, the treatment includes bed rest, medullary core decompression, and free vascularized fibula graft, but the outcome of the surgery is closely related to the patient’s symptoms, size and location of the necrotic lesion. Dr. Cory Edgar of Boston University Medical Center described their method of drilling and injecting autologous bone marrow to treat femoral head necrosis in the 2014 issue of Techniques in Orthopaedics. The method first originated from Gangji and Hernigou’s study and was modified by Cory et al. by first aspirating the bone marrow at the iliac crest through percutaneous puncture and then injecting the femoral head after decompression of the marrow core. I. Patient position and preparation. The patient is placed supine on a fluoroscopic surgical bed, and the pelvis is padded under the hip on the same side as the surgery so that the anterior superior iliac spine and the ilium are perpendicular to the trauma. The scope of disinfection is similar to that of hip replacement, but the superior and medial scope should include 1 cm above the iliac wing and medial to the navel. the C-arm X-ray machine is placed on the contralateral side for fluoroscopy. Bone marrow aspiration can be performed with a bone marrow aspiration needle or a bone biopsy needle, and the bone marrow can be collected at 180° using a 50 ml syringe with diluted heparin. Femoral head drilling Fluoroscopic drilling of the femoral head is performed. The area of femoral head necrosis is localized according to the preoperative MRI images, and the needle is penetrated through anterior-posterior and frog positions fluoroscopically. The position of the guide needle should be 1 to 2 mm from the subchondral bone to avoid penetrating the articular cartilage. Then a 4-mm diameter drill is used to drill multiple holes in the necrotic area, which can avoid the collapse induced by the reduction of the mechanical properties of the femoral head and can also provide adequate decompression of the necrotic area. Injection of bone marrow 20 ml of bone marrow fluid is injected slowly into the femoral head through the drill to promote contact between the bone marrow cells and the bone. When the injection is completed remove the drill and use absorbable thread to suture intradermally without leaving drainage fluid without suturing the fascia. V. Postoperative rehabilitation and exercise Bed rest for 1 month, support double crutches for 1 month, single crutches for 1 month, and limit activities such as running, jumping, and contact sports for 6 months after surgery because of the need to avoid excessive joint loading. Regular review. The authors used this method to treat some patients with ischemic necrosis of the femoral head, and most of them achieved pain relief to avoid femoral head collapse, but whether the course of ischemic necrosis of the femoral head can be reversed is still under continuous observation.