Femoral head necrosis, a relatively rare disease in the past, has become more and more common with the development of China’s economy and the change of people’s living habits. Before the 1980s, femoral head necrosis was mainly secondary to hip dislocation and femoral neck fractures caused by car accidents and trauma. With the increase of autoimmune diseases and rheumatoid rheumatic diseases, the widespread use of hormones, and the change of dietary habits – especially the large consumption of alcoholic beverages – the etiology and However, due to the large population base in China, the number of new patients with osteonecrosis of the femoral head each year cannot be underestimated. For this huge new group, neither patients nor doctors pay enough attention to it, from the patients, the performance of early femoral head necrosis is not outstanding, mainly the hip or groin area of the hidden pain and discomfort, sometimes also manifested as the knee joint parts of the discomfort, and this symptom is also manifested as sometimes light and sometimes heavy, people often think it is cold or sprained, eat some medicine or paste some ointment The pain is not relieved until it gets heavier and heavier, and the medication doesn’t help, which often delays the best treatment. From the doctor’s point of view, specific diagnostic indicators for early stage of femoral head necrosis have not been established yet, and most of them are diagnosed through medical history, physical examination and imaging performance. However, because the symptoms of early femoral head necrosis are atypical, patients’ expressions vary, and they are not obvious on X-ray, so that they are often not diagnosed in time. Although MRI is relatively much more sensitive, the high price prevents it from being widely used. This causes a large proportion of patients to miss the initial diagnosis and treatment. Since osteonecrosis of the femoral head occurs in young adults in their 30s and 40s, the damage it causes to patients and families is enormous. Although the current technology of total hip replacement offers hope for patients with end-stage femoral head necrosis, there are numerous reports in the literature that the survival rate of this group of patients is lower than average after replacement. The reason for this is that these patients are younger, are major members of society, and are more active, so they are bound to face a second revision surgery in their later years according to the service life of the existing prosthesis. This is the reason why surgeons should strictly control the indications for surgery and try to recommend early treatment to patients. So, what is early? Generally speaking, it takes about two years from the onset of femoral head necrosis (i.e., the onset of symptoms) to the collapse of the femoral head (requiring an artificial hip replacement), with some variation between individuals. This is the “prime time” for diagnosis and treatment, which is also known as the treatment window. During this time, the prognosis of femoral head necrosis can be improved or even the necrotic tissue can repair itself, thus delaying or even avoiding the fate of joint replacement, by evaluating the factors that affect the prognosis of femoral head necrosis: site, size, ratio, whether it is in the weight-bearing zone and the degree of necrosis. For patients how to self-evaluate the degree of femoral head necrosis staging, the development of the network makes it more convenient to obtain medical knowledge, so in my clinic you can see a lot of ARCO, Ficat staging said the head of the patient, but this kind of rigid application of half-knowledge is not good, the following I will be the knowledge of femoral head necrosis with illustrations for you to do an introduction. I hope to help patients, especially those with early stage osteonecrosis. In order to facilitate your understanding and also to combine the different clinical treatment methods, I divided the femoral head necrosis into early, middle and late stages. In the early and middle stages of the disease, the necrotic femoral head can be saved by various methods to maintain the “original mate”, while in the late stage, the femoral head is no longer regular on the X-ray and has collapsed, and some of them have even developed At this point, the time to save the femoral head has been lost, and the only way to save it is to replace it with a so-called “prosthetic joint” through artificial hip replacement. This is a patient whose course from the onset of the disease to the final surgery is a classic, and I hope we can get inspiration from his body. At the beginning of the disease, the right groin was uncomfortable, and no significant abnormality was seen in the local X-ray performance; the patient was seen as an outpatient after 2 months of non-remission of symptoms, and the review MRI showed a linear sign, suggesting early stage of femoral head necrosis, and the morphology of the femoral head was still acceptable. The patient was advised to undergo medullary core decompression, which was not accepted. Conservative treatment was performed, including weight reduction (crutch support), symptomatic pain relief, and oral vasodilator drugs to promote microcirculation, with a view to improving the condition. The patient’s condition was not significantly relieved, and symptoms also appeared in the left hip. 3 months later, the patient was re-examined again, and the X-rays suggested that the right hip had cystic lesions in the femoral head, which were located under the weight-bearing area and had a large area. Two months later, the right hip was reexamined again, the morphology of the femoral head changed, and the crescent sign appeared on the left side, and the symptoms were significantly worse than before. It was recommended that the right side undergo artificial total hip replacement and the left side undergo femoral head medullary decompression implantation, and the recommendation was accepted. After total hip arthroplasty on the right side, subchondral bone collapse in the weight-bearing area of the femoral head was seen on the left side. The necrotic femoral head after intraoperative amputation was seen to be collapsed with subchondral bone necrosis, separated from the cartilage, with obvious necrotic bone. The left side of the femoral head was decompressed with a fibula implant with a vascular tip, which not only decompressed the bone to promote vascular regeneration, but also restored the structural support of the bone to avoid collapse, and both X-ray and MRI indicated good postoperative changes. Six months after the operation, the patient was reviewed and it was seen that the distal end of the fibula had a tendency to resorb and fuse with the femoral head, and the osteosclerosis under the femoral head was obvious, and the MRI suggested that the painted necrotic area was significantly smaller, and the patient’s symptoms were also significantly relieved. At present, the patient’s condition is stable at long-term follow-up.