What to do when the femoral head is necrotic

  Ischemic necrosis of the femoral head is a common and frequent disease in orthopedics, and there is a saying among the people that femoral head necrosis is the bone cancer that does not kill people, which shows how much pain this disease brings to the patients. The hip joint is one of the largest joints in the human body, and its main function is to bear weight and lower limb walking function. The femoral head is the axis of the hip joint movement and also its main moving part. Any disease involving the femoral head will lead to the impairment of the lower limb walking function, which will seriously reduce the working ability and even make life unmanageable. It should be said that the femoral head is in a very important position in the human skeleton, so once the femoral head has a problem, it will bring a lot of inconvenience to people’s life, and even seriously affect the quality of life.  The main causes of femoral head necrosis are the following: traumatic; hormonal; alcoholic; decompression sickness; and hyperlipidemia-related diseases.  Although there are many treatments for femoral head necrosis, there are no more than “head preservation” and prosthesis replacement. For the treatment of femoral head necrosis, early conservative treatment such as medication and avoidance of weight-bearing can be applied, but the effect of medication is not certain. As for surgical treatment, except for a small number of non-surgical and interventional therapies, patients are generally treated by surgical methods, including medullary core decompression, medullary core decompression plus hematoprosthesis, bone grafting, osteotomy, hip fusion, femoral head repair and reconstruction, artificial joint replacement, etc. Patients with almost useless joints must undergo artificial joint replacement.  Artificial joint replacement is very common in Europe and the United States, in 1997, only 260 million people in the United States to implement total hip and knee replacement reached 550,000 cases, while China’s 1.2 billion people in 1999 only 16,000 cases. This huge contrast in numbers shows the huge potential of artificial joint replacement in China. With the rapid development of computer technology, computer-aided design and manufacturing of more personalized artificial joint prostheses has also entered the clinic. The highly technical and risky nature of artificial joint replacement requires very strict quality and skill in the surgeon’s surgical operation and postoperative care. At present, technical skills, concepts and funding are the main obstacles to the promotion of this procedure in China.