Principles of conservative treatment of femoral head necrosis

  I. Reduce weight bearing. Regardless of the period, walking on crutches, especially double crutches, can reduce pain and may have a certain protective effect on the femoral head.  Second, hyperbaric oxygen therapy. Treatment may be effective in early ischemic necrosis of the femoral head, especially in stage I patients.  Third, shock wave may have some effect. High-frequency oscillatory waves can improve microcirculation and promote blood vessels to grow into the necrotic foci, which is effective in relieving painful symptoms and can be used as an adjunct to the treatment of early femoral head necrosis.  Fourth, drugs. There is no drug with reliable efficacy to cure femoral head necrosis, but it may reduce the symptoms of early femoral head necrosis patients and slow down the progress of the disease.  (1) drugs to improve microcirculation by activating blood circulation: there are more and more confusing domestic Chinese medicine formulas. The main mechanism of action is to inhibit platelet release, reduce vascular inflammatory reaction, release vascular smooth muscle spasm, reduce whole blood and plasma viscosity and red blood cell pressure, and reduce the production of plasma fibrinogen. In addition, western medicine’s low molecular heparin has the effect of anticoagulation, reducing blood viscosity and improving fibrinolytic ability, which is widely used in the prevention and treatment of thromboembolic diseases. Some foreign scholars have applied it to the treatment of early femoral head necrosis and achieved good results.  (2) Lipid-lowering drugs such as statin lipid-lowering drugs: can improve lipid metabolism, lower blood lipids, reduce or avoid intraosseous vascular fat embolism. These drugs are generally used in patients with high doses of glucocorticoids to prevent the occurrence of femoral head necrosis.  (3) Anti-osteoporosis drug sodium allantoin: these drugs cannot repair the necrotic area, but can slow down the resorption of bone trabeculae in the necrotic area, enhance its bone density and slow down the collapse of the necrotic area.