Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): Patient male, 67 years old, right leg pain for many years, has been according to sciatica paste some ointment to promote blood circulation and relieve pain, or take some painkillers, limping. The pain has increased in the last two months, and sometimes the groin also hurts. At the end of last month, a DR film taken at a municipal hospital showed that the bone density of the right femoral head was uneven, cystic shadow was visible, and a crotch joint gap was present. The right femoral head was judged to be aseptic necrosis. The doctor said that surgical joint replacement is needed. For the time being, I will take some blood-activating and pain-relieving medications: Xianling Bone Capsules, Farnen, and pain-relieving medications. 1. Can the doctor confirm whether it is necrosis of the femoral head by looking at the film (some doctors say it is not)? Can you give me some advice on how to treat this problem and whether it can be cured if I take Tongluo Bone Capsules? Doctor: Hello, I have not seen the X-ray film, you provide incomplete clinical information, it is difficult to provide a detailed answer, please upload the X-ray film, MRI images and other test results, so that we can help you make a clear diagnosis online, to provide you with the correct specific diagnosis and treatment recommendations. Or see me at the clinic to provide you with further consultation and treatment directly. Patient: Hello, doctor! Thank you for your kind reply in your busy schedule. The profile photos have been circulated. Only X-rays are available now, and the doctor did not recommend any other tests. I will upload it again and look forward to your diagnosis. Doctor: Hello patient: According to your description, you are suffering from osteoarthritis of the hip joint, not ischemic necrosis of the femoral head. It has progressed to advanced stage and may need to be treated by artificial total hip arthroplasty. The surgical technique is very mature. Whether you need surgical treatment or not, please visit my clinic so that I can provide you with a clear diagnosis and treatment recommendation. Patient: Hello, doctor! Thank you for your reply. I would like to ask: Is the protocol the same if advanced femoral head necrosis and advanced osteoarthritis of the hip joint when total hip replacement is performed? What is the essential difference between osteonecrosis of the femoral head and osteoarthritis of the hip? Why do a number of doctors consider it to be osteonecrosis of the head of the femur. Is the final joint replacement surgery the same? Is the total cost 50,000-60,000 for the joint replacement the same as the imported material? I’m looking forward to your reply! Doctor: Osteoarthritis of the hip joint is a condition in which the cartilage on the articular surface of the femoral head first becomes diseased, and then involves the femoral head internally, causing changes such as cystic degeneration of the femoral head. In contrast, ischemic necrosis of the femoral head is caused by the destruction and interruption of blood flow in the femoral head and the development of lesions in the femoral head, such as cystic degeneration and collapse of the femoral head, which only involves the cartilage of the hip joint surface at an advanced stage. Both require artificial joint replacement surgery in advanced stages. Many physicians are unable to distinguish these differences and, therefore, tend to confuse them. The treatment for both is the same in advanced stages and requires artificial joint replacement surgery. We do both with imported joints at a cost of $50,000-$60,000. Patient: Thank you so much doctor! We would like to have the surgery next month or in the fall. Can I take some medication like Tongluo Bone Capsules or calcium tablets while waiting for the surgery? Is there anything I should pay special attention to for patients? Also, I read that there are some cases of post-operative infection, what are the causes? Doctor: Reduce weight bearing, take anti-inflammatory and pain-relieving drugs. Or operate as soon as possible. Patient: Thank you, doctor! If you are given an appointment for surgery, approximately how long will you be able to be hospitalized for examination? How long will it take to be discharged from the hospital after the surgery? 50-60K is it ceramic to ceramic or alloy to alloy? Doctor: It takes about 2-3 weeks to be admitted to the hospital for an appointment. The hospital stay is about half a month. 60,000 yen is for ceramic to ceramic, but we don’t do metal to metal anymore. Please come to see me in the outpatient clinic first so that we can propose a clear treatment plan for you.