Those who are inquiring about this article have probably been bouncing from hospital to hospital and clinic to clinic for a long time, with various medical institutions offering different opinions on treatment. The main dilemma faced by patients and their families is how to treat this disease? Can it be cured or not? Should we choose conservative or surgical treatment? What is the effect of surgical treatment? They wander between hospitals, outpatient clinics, and rural homes that offer prescriptions. Here I will talk about the standard treatment of this disease from a professional point of view. Femoral head ischemic necrosis, the etiology basically boils down to three main categories: 1 hormonal factors: this patient may have an underlying disease, intentional or unintentional application of hormones to treat the underlying disease. For example, patients with rheumatoid, ankylosing spondylitis, systemic lupus erythematosus, and hematologic diseases have to apply hormones to control their conditions, resulting in ischemic necrosis of the femoral head. Patients with asthma, chronic bronchitis, emphysema and other respiratory diseases have to apply hormones to control attacks. Patients with back and leg pain, who listen to various legends and receive treatment with pills or capsules formulated by informal medical institutions, find that the application of this drug can reduce pain or no pain at all. So they rely on this drug for a long time, and suddenly one day they find that they have difficulty walking on the bed, or squatting, and only then they go to the hospital, because the pain is not obvious because of the application of hormones. However, once discovered, the pain is often very serious. Another phenomenon is that patients with skin diseases, topical application of drugs containing hormones, or the use of hormonal drugs to control allergies, occasional behavior, but also found to induce the disease. In other serious medical diseases, the use of medication during resuscitation in order to save lives has caused this disease, as in the case of patients after SARS, almost without exception, femoral head necrosis. It should be noted that the hormonal drugs discussed here from the perspective of inducing the disease alone, discredit the positive therapeutic effect of hormonal drugs, in fact, hormones are a kind of drugs with very certain therapeutic effect, and are a kind of miracle drug when used well.2 Alcohol factor: Although it is a recognized causative factor that prolonged heavy alcohol consumption can cause femoral head necrosis, the mechanism is still not very clear. Clinical observations have found that the two do correlate: long-term drinking can cause necrosis, but it is not known exactly how much is drunk daily on necrosis. The purpose of this is to show that alcohol is a causative factor. But this causative factor also has a lot to do with the individual’s constitution. I have observed elders around me who have been drinking alcohol for most of their lives, and the amount is not small, but so far no femoral head necrosis has occurred. Therefore, physical factors play an endogenous role.3 Trauma factors: After hip fracture, the probability of femoral head necrosis is high, with specific reports of incidence ranging from 50% to 90%. Especially after femoral head fracture, femoral neck fracture and hip dislocation, femoral head necrosis is more likely to occur. There are also patients who simply sprained their hip from a fall and were able to walk and tolerate the pain, but after a long period of time, they developed hip pain and were diagnosed with the disease. There are other cases of this disease where there is no cause. The cause of the disease is different, and so is the treatment effect. If we analyze the treatment specifically, I will use stage I and II as an example to explain the effect of conservative treatment. The so-called stage I and II is the period when the lesion is just found on the X-ray and MRI film and the femoral head is not collapsed, during which conservative treatment can be chosen. I will elaborate my personal viewpoint for the reference of those who need it: Stage I and II patients have room for conservative treatment, so they can choose conservative treatment, calcium supplement, improve cartilage metabolism, reduce synovial edema, anti-inflammatory and analgesic drugs, reduce weight, bicycle walking, and strengthen hip joint grinding. Chinese herbal medicines to tonify the kidneys and warm the yang are also effective. These are some of the more certain treatments. If the patient’s pain is very heavy and unbearable, and the conservative effect is not good, you can consider intramedullary decompression surgery, which can have immediate effect by simply punching and decompressing in stage 1, and can also be used in stage IIA. Stage IIB adopts incision and slotting to decompress and autologous iliac bone punching and bone grafting, and the surgical effect is also very good. However, for hormone-induced osteonecrosis, the effect of conservative treatment may be very poor, and it often develops into severe osteonecrosis of the femoral head very quickly. patients with Ficat stage III and IV mainly refer to patients whose femoral head has collapsed, the joint space has narrowed, the articular surface has hardened, and the acetabular rim is obviously bony, because the articular cartilage is stripped, degeneration and cancellous bone in the femoral head has undergone bean curd-like necrosis or Therefore, it is basically impossible to change the tissues that have undergone complete pathological changes through medication alone, but this is also in accordance with the law of nature. Therefore, for patients in this period, if conservative treatment is used, it is basically ineffective and should be ineffective. For patients in this period, this outcome may be disappointing. Reluctance to accept the fact that surgical treatment is necessary. Every effort is made in the hope that surgery will be dispensed with through magical conservative methods of treatment. So believe in all kinds of conservative methods, pills, pans, creams, wine, washing, moxibustion, pushing, 18 generations of ancestral famous doctors’ treatment methods, try them all over, spend all the savings, still the condition is getting worse day by day. So then, back to the regular hospital, had no choice but to undergo surgery. After the surgery, patients often lament that if I had known that the surgery was so effective, I wouldn’t have to suffer these years. Therefore, I advise patients who have reached this stage, if you have a good stomach, a lot of money and a strong will, you should try conservative treatment methods before surgery. If your family is not rich and you don’t have people living to care for you, get together the limited high cost of surgery and resolutely use surgical treatment. This is the wise choice. It is more scientific and practical to choose the treatment plan for ischemic necrosis of the femoral head according to the stage. We ask patients who need help to be able to overcome their illusions and follow the objective reality in the right place.