Ischemic necrosis of the femoral head is a common and difficult to treat orthopedic disease that occurs in high-risk groups with long-term drinking habits, hip injuries, or those who have taken hormones for certain diseases. The symptoms can be relieved after taking general anti-inflammatory and analgesic drugs or taking a short rest, so the patient’s attention is not drawn to it. With the further development of osteonecrosis, the patient’s pain will increase, squatting and cross-legged activities will be affected, and limping will occur. The key to the management of ischemic necrosis of the femoral head is early diagnosis and early treatment. Recent medical research has shown that different treatment methods should be used at different times, so that not only the femoral head can be preserved, but also the necrotic femoral head can be gradually restored to normal. For the treatment of femoral head necrosis, different treatment methods must be used according to its different pathological changes. At present, the best early treatment is to use a combination of Chinese and Western medicine, such as minimally invasive surgery to remove necrotic bone, decompression drilling, soft tissue release, bone grafting, osteotomy and other techniques supplemented by Chinese medicine to invigorate blood, tendons and bones, internal and external medicines and electrical stimulation and traction methods. As for the advanced cases, patients with obvious collapse of the femoral head and osteoarthritis have to perform artificial joint replacement or joint fusion. Since 1999, the Department of Orthopaedics of Xiyuan Hospital has been focusing on ischemic necrosis of the femoral head as a key research topic, and has developed a series of treatments for early and late stage femoral head necrosis by combining the specialties of Chinese and Western medicine. In particular, the use of arthroscopic bone grafting, decompression and flushing has achieved satisfactory results in preserving the necrotic femoral head of young and middle-aged patients. Classic consultation record: Patient: I am a patient who has just been diagnosed with stage II osteonecrosis of the femoral head, with a large area of osteonecrosis and collapse, but usually no pain. The doctor said my age was too young to do surgery, and there was no good way to treat the condition as it is now. He just prescribed some medication to recuperate at home, and told me to walk with a car and try to use crutches. The medications are deer melon polypeptide injection, Jin Wu Bone Tong capsule and Celecoxib capsule. Are these medications useful? Answer: Early stage of femoral head necrosis can be removed arthroscopically with dead bone removal and minimally invasive bone grafting under arthroscopy. We have treated many patients like you and the success rate is over 95%. This is one of the most advanced methods in China. Patient: Is it a bone graft with blood vessels? What about the collapsed one, how long will it take to heal, what is the approximate cost, and can I get medical insurance? Answer: You are welcome. We use a bone graft without blood vessels. If it has collapsed, at least beyond the second stage, a mild collapse can still be repositioned with pressure. If the collapse is severe, conservative treatment is not appropriate and joint replacement surgery may be necessary. The cost is about 15,000 per side, which can be covered by medical insurance in Beijing, but for foreign patients, they have to be transferred to a local hospital and the local government will agree to cover the cost. Patient: Can my joint still be repositioned with pressure? How to do the surgery? Sun Jianfeng, Department of Orthopedic Injury, Xiyuan Hospital: I think your case can be done with microscopic bone grafting, and it is necessary to do it as soon as possible to avoid aggravation and collapse in the short term. We suggest you to visit the outpatient clinic for the specific situation. Patient: How long will it last after bone grafting, and if it doesn’t work anymore, can I still do artificial joint surface replacement? Answer: If the bone graft heals well after implantation, the femoral head will not collapse again, but if it does not heal completely or does not heal, there is a possibility of collapse. The longest one since we conducted this study is still in good condition and can still play ball. If the surgery is not successful, joint replacement is still possible. This is because we only remove the necrotic bone and implant new bone without destroying the normal bone. This is a minimally invasive treatment option before joint replacement. If you come to the hospital, make an appointment with me in advance. Total hip replacement is usually performed for femoral head necrosis.