Our concern for ischemic necrosis of the femoral head in adults

  The International Association Research Circulation Osseous (ARCO) and the American Academy of Orthopaedic Surgeons (AAOS) define ischemic necrosis of the femoral head as a disruption or impairment of the blood supply to the femoral head, causing ischemic necrosis is defined by the American Academy of Orthopaedic Surgeons (AAOS) as a disease in which the blood supply to the femoral head is interrupted or impaired, causing death and subsequent repair of bone cells and bone marrow components, followed by structural changes in the femoral head, femoral head collapse and joint dysfunction. Femoral head ischemic necrosis is still recognized as one of the most difficult orthopedic diseases in the world.  Femoral head ischemic necrosis is generally divided into two categories: the former is mainly caused by hip trauma (femoral neck fracture, hip dislocation, acetabular fracture, etc.); the latter has nearly 70 kinds of causative factors, and in China, the top two causes of non-traumatic femoral head necrosis are, application (including abuse) of corticosteroids (prednisone, cortisone, dexamethasone, etc.) and long-term heavy alcohol abuse. It is speculated that there are 100,000-150,000 new cases of ischemic necrosis of the femoral head in China each year, and the cumulative number of cases requiring treatment exceeds 5 million. There are currently about 30 million patients worldwide.  Since the world medical community first recognized the disease of femoral head necrosis in 1888, femoral head necrosis has been transformed from an uncommon disease to a frequent and common disease. The reasons for this are: ① Since the introduction of hormones and their widespread use, how many lives have been saved, but hormones bring toxic side effects to human beings while curing diseases and saving lives, doctors often seem helpless. Hormonal necrosis of the femoral head is the leading cause, and hormone abuse has become the number one killer of femoral head necrosis; ② the increasing number of alcoholics, especially high concentration of liquor; ③ the change of transportation, the increase of traffic accidents, and the increase of hip injuries among young and middle-aged people aged 30 to 50; ④ the aging of the population and the increase of femoral neck fractures due to osteoporosis; ⑤ the development of science and technology: radiation, caisson disease, birth control pills, organ transplantation, etc. (6) MRI enables early detection of patients who could not be diagnosed by X-ray.  In my nearly 30 years of clinical work, most of the patients with femoral head necrosis have progressed to stage II or above, and even stage III and IV are mostly diagnosed, for the following reasons: ① hormone abuse and lack of diagnostic tools for patients with early symptoms (MRI is not configured in primary hospitals); ② lack of scientific knowledge about ischemic necrosis of the femoral head; ③ false advertising; ④ also with the doctors’ awareness and attention to the high-risk group of possible ischemic necrosis of the femoral head The lack of awareness and attention to the high-risk group and the lack of understanding of the challenges of treating ischemic necrosis of the femoral head. Therefore, it is deeply felt that patients with ischemic necrosis of the femoral head should be aware of the relevant knowledge, which is crucial for patients.