Despite the tremendous progress in artificial hip technology, this surgical technique for elderly patients with advanced hip disease still has many inherent disadvantages for the vast majority of patients with osteonecrosis of the femoral head who are still very young (about 36 years old on average), so avoiding or delaying the replacement of artificial joints in patients with osteonecrosis of the femoral head is the consensus and direction of effort of almost all orthopedic specialists. However, the fact that more and more patients with osteonecrosis of the femoral head in China are being advised to need artificial joint replacement is rooted in the fact that there are major problems in the early diagnosis and treatment of osteonecrosis of the femoral head. (1) Those who use hormones (dexamethasone, prednisone, methylprednisolone, etc.) for a long time and in high doses need to have a double hip MRI (magnetic resonance imaging) examination after about six months of use to rule out femoral head necrosis, instead of waiting for pain to appear before going for examination. (2) The advantage of TCM is prevention and early treatment, but since few people get early diagnosis, most of the patients actually treated by TCM are not early stage patients, as a result, many people complain that TCM is not effective, which is actually a big misconception. (3) For long-term high-dose hormone users, once hip pain occurs, it often suggests that femoral head necrosis is no longer early, and most of them have collapsed or intra-head fracture, and most of them need surgical intervention at this time. But in reality, many patients always mistake the pain as early stage of necrosis, and stubbornly believe that since it is early stage, it is better to take a look at conservative treatment first, and then operate, even though the pain will be temporarily relieved through conservative treatment, not knowing that with the delay of time, the last golden opportunity of hip preservation treatment is lost, and when it is really not possible, it is already to the point of joint replacement. (4) For long-term alcoholics, once hip pain occurs, it is recommended to immediately go to a joint specialist for an examination of the femoral head necrosis specialist, and an X-ray and magnetic resonance imaging (MRI) examination will clarify the presence of femoral head necrosis. (5) Not all cases of necrosis require surgery. For early necrosis with no pain, no bone marrow edema, no intra-capital bone fracture, and necrosis with less than 30% necrosis, necrosis located in the medial or central femoral head (lateral column intact), non-surgical treatment based on Chinese medicine can be used, while regular review, many patients can obtain clinical cure. (6) Collapsed femoral head necrosis is not the same as the need for joint replacement. For patients with relatively mild collapse (less than 4mm), collapse time less than 6 months, and relatively young patients, hip preservation surgery such as compression support bone grafting or dead bone removal, compression bone grafting, and bone flap grafting with blood vessels can be used, which can make more than 80% of patients obtain satisfactory results. In conclusion, the diagnosis of femoral head necrosis can be made earlier and earlier by existing methods; if the indications are properly selected, non-surgical treatment methods mainly based on Chinese medicine can achieve good results; once pain occurs, most of them need to be combined with surgical procedures; minimally invasive compression-supported bone grafting is one of the most effective methods before collapse and early after mild collapse; after collapse of femoral head necrosis occurs, it does not necessarily mean that artificial joints need to be replaced. With proper selection of indications, dead bone removal, compression bone grafting, and bone flap grafting with blood vessels still have a success rate of about 80%, only that the recovery time needs to be longer; reducing artificial joint replacement in patients with femoral head necrosis not only has important clinical value, but also has important scientific significance.