The implementation of interventional means for the treatment of femoral head necrosis is mainly concentrated in the radiological community, and orthopedic surgeons are less likely to implement it and are skeptical about the basis and efficacy of the treatment. The use of this method for the treatment of femoral head necrosis is mainly concentrated in small and medium-sized hospitals and staff hospitals, and less in large teaching hospitals. Although a few papers have been published so far, they are limited to local journals, and domestic mainstream journals are still cautious. From the papers published so far, none of them can stand up theoretically, and none of them is a summary of the medium and long-term efficacy according to the evidence-based medical method, and most of them are just speculation. Theoretically, the interventional treatment of femoral head necrosis is untenable. Femoral head necrosis is divided into two categories: trauma and non-trauma. The former cause is clearer, that is, femoral neck fracture or hip dislocation, etc. damaged the main nutritive blood vessel DD epiphyseal artery in the weight-bearing area of femoral head, while the latter cause is still being explored in depth, and it is speculated that the direct action of corticosteroids, alcohol or its metabolites in the body damage the bone marrow endothelial cells, causing the embolism of blood vessels in the bone marrow, resulting in the death of bone cells and bone marrow components due to the embolism of blood vessels in the bone marrow. However, whether arterial embolism precedes or is secondary to venous embolism is still debated. Perhaps the advocates of interventional treatment of femoral head necrosis were inspired to implement thrombolytic therapy for myocardial infarction and cerebrovascular embolism. The use of pharmacological thrombolysis for cardiovascular embolism does have excellent efficacy. However, the timing of treatment must be mastered. It has been reported that myocardial infarction should be treated within 12 hours of onset, while treatment efficacy is best within 2-3 hours and decreases with time. In contrast, the time window for treatment of cerebrovascular thrombosis is 3 hours for intravenous thrombolysis and 6 hours for arterial thrombolysis. If the above time limit is exceeded, other methods of treatment will be used. Even if it is certain that the femoral head necrosis is caused by embolism of small arteries in the bone, according to the current level of diagnosis, the shortest interval between the start of corticosteroid osteonecrosis medication and a positive magnetic resonance imaging (MRI) (stage I) is 4 weeks, according to the latest data. Since most of the femoral head necrosis has no clinical symptoms and signs in the early stage, it is difficult to alert patients and physicians. Waiting for the appearance of symptoms such as hip pain and claudication, or waiting for X-ray and CT scan to show positive changes, the shortest interval is 6 months according to our study on the natural history of osteonecrosis in SARS (natural history). The use of intravenous perfusion control agent power MRI scan can be explored to show arterial perfusion changes within 72 hours after drug administration, but it is still in the animal experiment stage, and further research is needed for application to clinical diagnosis. Angiography of stage II and III femoral head necrosis showed that the necrotic area was not visualized at all, suggesting the absence of blood circulation in this region (Figure 1). Therefore, the interventional method of injecting all kinds of thrombolytic drugs approved by the State Food and Drug Commission (CFDA) cannot enter the necrotic zone without blood vessels, and dissolving the long-established thrombus to achieve the therapeutic effect is undoubtedly lack of scientific basis, unless people with ulterior motives claim to use the so-called partial prescriptions, experimental prescriptions, and ancestral secret recipes to deceive patients. Second, clinical practice proves that interventional treatment of femoral head necrosis is ineffective According to the center for osteonecrosis and joint preservation and reconstruction of China-Japan Friendship Hospital, about 1/3 to 1/2 of the patients with advanced femoral head necrosis have received interventional treatment, the most being four times. The femoral heads of these patients eventually collapsed and severely affected joint function, necessitating artificial joint replacement. Even in early cases (stage I), interventional treatment was not effective. All eight cases of post-SARS osteonecrosis treated at our center were diagnosed within 3 months after the application of high-dose corticosteroids, and all were treated with interventional therapy, which showed that these patients were ineffective in the early stage (pain persisted or worsened) and progressed to stage II or III in the middle stage, and were treated with joint-preserving surgery. If interventional treatment is performed on patients with stage I or II femoral head that has not yet collapsed, the starting point is presumed to be good from good intentions, but the final outcome is still contrary to what is desired. Some authors insist on interventional treatment for some patients with femoral head necrosis that has reached stage III (beginning of collapse) or stage IV (joint damage), which is inappropriate and ineffective (Figure 2). Femoral head necrosis is a progressive disorder. Once the femoral head is necrotic, the repair mechanism in vivo causes the intramedullary vessels to gradually enter the necrosis in an attempt to repair the necrotic area. However, the body’s ability to repair itself is limited, and in the case of ischemia, a sclerotic zone often forms at the edge of the necrotic area, which can be clearly shown on a CT scan. Once the sclerotic zone is formed, it means that the self-repair stops, and without surgical or other invasive means (e.g. extracorporeal shock wave) intervention, the necrotic area cannot be repaired, and even interventional treatment is ineffective (Figure 3). Interventional treatment of femoral head necrosis is harmful in addition to ineffective. At present, the commonly used method in China is to enter the selected internal femoral artery through the femoral artery cannula to inject drugs, and the cannulation process can damage the endothelial cells of blood vessels and also form inguinal hematoma after extubation, which can cause pain to patients. The complication of peripheral tissue bleeding during arterial thrombolytic therapy should not be ignored either. As for the economic loss, it is even more disastrous. The cost of each intervention is around 10,000 yuan. Some patients spend all their savings on the interventional treatment, and some even sell their properties and become heavily indebted, but when they really need to do joint preservation surgery or advanced artificial joint replacement, they are already empty-handed and have to give up the treatment. Such a tragic situation is heartbreaking, but also angry, helpless. Here I cautiously appeal to the conscientious medical staff should take the interests of patients as the first priority, the serious and careful evaluation of the significance and value of interventional treatment of femoral head necrosis. Third, femoral head necrosis should be diagnosed early, scientific treatment Because the cause of femoral head necrosis is not yet fully understood, so the treatment for the cause is still exploratory and blind. However, the consensus of experts at home and abroad is that if femoral head necrosis can be diagnosed at an early stage (Ⅰ, Ⅱ), individualized scientific treatment plan can be formulated for the size of necrosis area, location and patient’s age, occupation, etc. The excellent rate of preserving their own joints for 10~15 years is still above 80%. The specificity and sensitivity of MRI examination for the diagnosis of femoral head necrosis are above 95%, which provides an accurate non-invasive and non-invasive examination means and basis for early diagnosis, but it should be used for differential diagnosis with other hip diseases. Therefore, it is recommended that high-risk patients suspected of femoral head necrosis (taking corticosteroids, alcoholism, hip trauma, high coagulation and low fibrinolytic tendency, etc.) should go to a large hospital for specialist examination as early as possible to confirm the diagnosis and treatment so as to avoid detours or being deceived.