New hope for aseptic necrosis of the femoral head

  Femoral head ischemic necrosis, also known as aseptic necrosis, is a common surgical disease caused by necrosis of the active components of the femoral head (bone cells, bone marrow cells, adipocytes, etc.) due to various causes of unilateral or bilateral impaired blood supply to the femoral head, with large doses of hormones, long-term inordinate alcohol consumption, and trauma being common causes. Progressive necrotic lesions of the femoral head can lead to the collapse of the weight-bearing surface of the femoral head under pressure and loss of joint function. The clinical manifestations are pain around the hip joint and the front inner thigh to varying degrees, hip movement disorders, limb shortening and even loss of function.  According to the symptoms and imaging performance, it can be divided into 5 stages: stage I is characterized by painful symptoms but no imaging performance of femoral head necrosis; stage II is characterized by different degrees of pain around the hip joint and anteromedial thigh, impaired hip joint movement, imaging performance of cystic changes in the femoral head, while the femoral head is intact and smooth in shape and the hip joint gap is normal; stage III is characterized by increased pain, significantly restricted hip joint function, the femoral head appears In stage IV, the pain continues to worsen, the femoral head further collapses, the hip joint gap becomes narrower and disappears, and the joint function is obviously restricted; in stage V, the joint function completely disappears. The aim of clinical treatment is to reduce pain, restore hip joint motion function, and reduce or avoid limb deformity. Different treatment methods are suitable for different stages of development. For lesions above stage IV, artificial hip replacement should generally be the first choice, and for lesions within stage III, internal conservative treatment can be chosen first.  The core problem of ischemic necrosis of the femoral head is the impaired blood supply to the femoral head caused by various reasons. Regardless of the medical method, the goal is to improve the local blood circulation of the femoral head. Anatomically speaking, the blood supply arteries to the femoral head, femoral neck and hip joint are mainly the closed-space arteries from the internal iliac artery (of which the femoral head round ligament artery enters the femoral head directly) and the internal and external spinous femoral arteries from the beginning of the deep femoral artery.  Interventional lysis is a new technique that combines interventional technology with Chinese and Western medicine drug treatment. Through the super-selective cannula of the above-mentioned small arteries, Chinese and Western medicines with the effects of dissolving thrombus, activating blood circulation, dilating blood vessels and improving microcirculation are directly injected into the blood supply arteries of the femoral head.