Ischemic necrosis of the femoral head is a lesion caused by poor local blood circulation in the femoral head due to various reasons, which leads to ischemia, necrosis, trabecular fracture, and collapse of the femoral head. If the diagnosis and treatment are not timely, improper care can eventually lead to lifelong disability.
What are the symptoms of osteonecrosis of the femoral head?
1, most patients with femoral head necrosis have a history of femoral neck fracture or hip injury, or a history of overuse of hormones, or a history of alcoholism.
2.Hip joint pain. At first, the pain is mostly hidden, sore and dull, with intermittent attacks or progressive aggravation, and the pain will increase after too much activity, and the pain is also more obvious at night, and the pain can also radiate along the inner thigh to the knee. Due to the pain, the patient may experience limping and difficulty squatting. Later on, pelvic tilt, scoliosis deformity and other lesions may also occur.
3. There is pressure pain around the affected hip joint, such as the midpoint of the groin, the inner thigh root, and the back of the hip joint.
4. The range of motion of the hip joint is restricted, and the restriction of internal rotation and abduction appears earlier and more obvious.
What kind of examination should be done for femoral head necrosis?
1.X-ray examination. Clinically, it can be divided into four stages: stage I, slightly osteoporotic; stage II, normal appearance of the femoral head, visible intracapsular area and osteosclerosis at the edge; stage III, collapse and deformation of the femoral head, the femoral head is not round and smooth or flattened; stage IV, on the basis of stage III, there is narrowing of the joint space and osteophytes. However, the X-ray changes in stage I are not obvious, and the clinical diagnosis is often confirmed after stage II.
2.CT examination, MRI examination and isotope scan can provide earlier and more accurate diagnostic basis.
3, blood biochemical examination, often suggests that the patient has increased blood lipids.
Third, how to treat femoral head necrosis?
(i) Non-surgical treatment.
1.Limit weight-bearing. It can reduce the pressure on the femoral head, relieve the pain, and avoid the femoral head collapse and collapse aggravation 2, traction therapy. It can relieve the spasm of soft tissues, reduce intra-articular pressure, improve blood circulation and reduce pain; and can correct some deformities, such as joint deformities caused by contracture of soft tissues of serious sub.
3.Intravenous injection of salvia, etc. Salvia has the function of regulating lipid metabolism, lowering blood lipids, improving the high viscosity of blood, reducing the damage of vascular endothelial cells, inhibiting coagulation, expanding peripheral blood vessels, increasing blood volume and improving microcirculation, so as to improve blood circulation within the femoral head and treat ischemic necrosis of the femoral head.
4.Therapeutic identification of Chinese medicine. The needs of patients who are reluctant to undergo surgery can be met through the three-stage discriminatory treatment with Chinese medicine.
(ii) Surgical treatment.
1.Drilling decompression surgery and/or hip joint washout. It is a minimally invasive surgery with little pain, quick recovery, no need to meet the needle, does not affect the normal structure of the hip joint, can better reduce pain, control the development of necrosis and improve the quality of life, and is suitable for the treatment of patients with stage I and II femoral head necrosis.
2.Marrow core decompression plus artificial bone grafting. Bone grafting is divided into autologous bone grafting and artificial bone grafting. Through the navigation system, the femoral head is decompressed and the dead bone is scraped away, and then bone blocks and bone particles are implanted and filled in to provide mechanical support and promote the crawling of new bone, which is conducive to the repair and reconstruction of femoral head necrosis, and is suitable for patients with stage I and II femoral head necrosis. The artificial bone implant does not need to be removed separately, and can avoid the occurrence of allogeneic rejection.
3.Vascular grafting. Vascular grafting can provide good blood flow to the femoral head, but the mechanical support factor for the femoral head is not good. It is suitable for the treatment of patients with stage I and II femoral head necrosis.
4. Bone graft with vascular tip. Bone graft with vascular tip can effectively provide blood supply to the femoral head, while reducing the internal pressure of the femoral head, removing the dead bone and implanting fresh cancellous bone can play the role of osteoinduction, while providing mechanical support to the femoral head. It is suitable for stage II and III patients.
5.Femoral head or hip arthroplasty. Artificial joint replacement is a treatment method to replace the necrotic, deformed and hyperplastic femoral head and acetabulum with artificial materials to improve their functions. It is suitable for the treatment of patients with stage IV and joint dysfunction.
Fourth, what should be noted in the life of patients with femoral head necrosis?
1.Prohibit drinking alcohol!
2, stop using hormones and other drugs as much as possible (except for special cases)
3.Avoid weight bearing on the affected hip joint. You should walk on crutches to avoid accelerating the collapse of the femoral head and aggravating the condition.
4.Do functional exercises of the hip joint without weight-bearing. Such as lying flat on the bed, legs do upward pedaling action.
5.Using traditional Chinese medicine techniques to do moderate treatment.
6, reasonable outdoor activities, appropriate light. It can promote the synthesis of vitamin D and the absorption and metabolism of calcium.
7.Dietary care. Eat calcium-rich food.
8, early consultation with a doctor.