Patient: Description of the condition (onset time, main symptoms, hospital visited, etc.): The patient is male, 67 years old, has been suffering from pain in his right leg for many years, and has been limping according to sciatica with some ointment to activate blood circulation and relieve pain, or some painkillers. In the last two months, the pain has increased, 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 Dr. Guo show the film to confirm whether it is necrosis of the femoral head (some doctors say it is not)? How many stages does it need to be operated? 2.Can you give some treatment suggestions for the current plan? 3. Can I be cured if I take Tongluo Bone Capsules? The orthopedic department of Beijing Jishuitan Hospital, Guo Xiaozhong: Hello, I have not seen the X-ray film, the clinical information you provide is incomplete, 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 and 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, Director Guo! Thank you for your 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 them again and look forward to your diagnosis. Hi 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, please visit my clinic so that I can provide you with clear diagnosis and treatment recommendations. Patient: Hello, Director Guo! Thank you for your reply. I would like to ask: Is the plan the same if advanced femoral head necrosis and advanced osteoarthritis of the hip joint when total hip replacement is done? 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! Beijing Jishuitan Hospital Orthopaedic Department Guo Xiaozhong: Hip osteoarthritis is a condition in which the cartilage of the articular surface of the femoral head first becomes diseased and then involves the internal part of the femoral head, 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.