Surgical treatment of osteonecrosis of the femoral head is usually based on the size and severity of the lesion. Here we introduce the surgical treatment options for osteonecrosis of the femoral head in detail. We will help you to choose the right treatment method and overcome the disease as soon as possible. 1.Drilling decompression surgery for femoral head necrosis 2.Bone grafting surgery for femoral head necrosis 3.Bone marrow stem cell surgery for femoral head necrosis 4.Arthroplasty for femoral head necrosis Drilling decompression surgery can reduce intraosseous pressure, promote venous reflux, release trophoblastic vascular spasm and enable new blood vessels to grow into the ischemic area along with the bone hole. It is mainly used for patients without early joint surface collapse and is the simplest method of surgical treatment for femoral head necrosis, but there has been controversy about this treatment method. Although it can relieve pain for a certain period of time, it cannot slow down the rate of disease progression. Moreover, decompression is likely to accelerate the rate at which the collapse process occurs. Because the drilling itself destroys the bone structure, many people cannot form bone tissue in the drilled area after surgery, which will weaken the weight-bearing capacity of the femoral head and make it prone to microfractures and accelerate the onset of collapse. Because drilling is required before bone grafting, it is also called drilling decompression osteotomy. There is both drilling and decompression, bone grafting to provide mechanical support, and bone grafting with myofibula to increase the blood supply to the femoral head. Theoretically, the vascularized fibula graft can accelerate the process of recanalization and facilitate the repair of the necrotic femoral head. However, complications such as deep vein embolism, bunion ptosis and peroneal neuropathy due to peroneal nerve palsy are as high as 22% in the group of fibular graft with vascularized tips, and normal bone structure cannot be restored. The reason is that the necrotic lesion is close to the bony articular surface, and it is impossible to completely remove the necrotic tissue in the middle of this surgical treatment for femoral head necrosis; and the removal of necrotic tissue inevitably destroys the blood supply and causes new necrosis; thirdly, the number of blood vessels entering the femoral head is still insufficient, and the entry points are not dispersed enough, and the filled loose implants cannot induce osteogenesis due to insufficient blood supply, but form dense fibrous tissue, which prevents New bone formation is prevented. Bone marrow stem cells can produce osteoblasts, chondroblasts and fibroblasts, so people think of the method of decompression of the marrow core while extracting red bone marrow and injecting stem cells into the necrotic area of the femoral head to treat femoral head necrosis. This surgical treatment of femoral head necrosis is performed by extracting 300 cc of red bone marrow from the anterior superior iliac crest at multiple points using a syringe containing heparin. After filtering, fat and blood clots are removed, and then 50 cc of suspension containing a large number of stem cells can be concentrated and extracted through a separator, and then injected into the cavity of the medullary core decompression. The problem is: 1. I don’t know how many stem cells are appropriate to be injected. 2.Stem cells can only be transformed into bone cells under certain environment, and they can only die when there is no blood supply, and can only form fibrous tissue when the blood supply is poor. When the blood supply is good, cartilage can be formed, and only when the blood supply is sufficient can bone tissue be formed. The consequences of injecting stem cells into a necrotic area with almost no blood supply can be imagined, and there are no reports of success to date. If your lesion is advanced or extensive, the only effective approach is total hip replacement. This surgical treatment for femoral head necrosis, total hip arthroplasty, is one of the most successful inventions, but the life expectancy of a total hip replacement with current technology is unlikely to be that long. The life expectancy of the hip joint is generally only 10-15 years, with the added problems of infection, loosening and dislocation, prosthesis loosening, and acetabular wear. To avoid dislocation, hip flexion cannot exceed 90 degrees also causes much inconvenience to the patient.