Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): Patient male, 67 years old, right leg pain for many years, has been according to sciatica paste some ointment to promote blood circulation and relieve pain, or take some painkillers, limping. The pain has increased in the last two months, and sometimes the groin also hurts. At the end of last month, a DR film taken at a municipal hospital showed that the bone density of the right femoral head was uneven, cystic shadow was visible, and a crotch joint gap was present. The right femoral head was judged to be aseptic necrosis. The doctor said that surgical joint replacement is needed. For the time being, we will take some blood-activating and pain-relieving drugs: Xianling Bone Capsules, Farnen, and pain-relieving drugs. 1. Is it osteonecrosis of the femoral head (some doctors say no)? 2. Can you give me some treatment suggestions for the current plan? 3. Can it be cured if I take Tongluo Bone Capsules? Doctor: According to your description, you are suffering from osteoarthritis of the hip joint, not ischemic necrosis of the femoral head. It has progressed to advanced stage and may need to be treated by artificial total hip arthroplasty. The surgical technique is very mature. Please visit our outpatient clinic for a definitive recommendation on whether you need surgical treatment. Osteoarthritis of the hip joint is a condition in which the cartilage of the articular surface of the femoral head first becomes diseased and then involves the inside of the femoral head, causing changes such as cystic degeneration of the femoral head. In contrast, ischemic necrosis of the femoral head is caused by the destruction and interruption of blood flow in the femoral head and the development of lesions in the femoral head, such as cystic degeneration and collapse of the femoral head, which only involves the cartilage of the hip joint surface at an advanced stage. Both require artificial joint replacement surgery in advanced stages. Many physicians are unable to distinguish these differences and, therefore, tend to confuse them. The treatment for both is the same in advanced stages and requires artificial joint replacement surgery. We do both with imported joints at a cost of $50,000 to $60,000. Patient: We would like to have the surgery next month or in the fall. Can I take some medication like Tongluo Bone Capsules or calcium tablets while waiting for the surgery? Are there any special considerations for patients? Also, I read that there are some cases of post-operative infection, what are the causes? Doctor: Reduce weight bearing, take anti-inflammatory and pain-relieving drugs. Or operate as soon as possible. Patient: How long will it take to be discharged from the hospital after surgery, and is the $50,000-60,000 ceramic to ceramic or alloy to alloy? Doctor: Half a month in the hospital. 60,000 yen or so is ceramic to ceramic, we don’t do metal to metal anymore.