Femoral head necrosis, why not blindly seek only pain relief?

  Some patients do not want to have surgery that soon and want to delay it as long as possible. What are the dangers of blind delay? What is the impact on the patient’s future surgery?  It is true that all surgeries have certain risks, and although artificial joint replacement is a mature surgery, there are still some potential surgical risks, just like any other surgery. Some people think that there is no risk if they do not have surgery, but in fact, not having surgery is not completely without problems.  First of all, because osteonecrosis of the femoral head will be painful, making it difficult for the patient to walk or walk poorly, which will obviously affect the quality of life; at the same time, over a long period of time, the bone on the side of the osteonecrosis of the femoral head may become loose due to the reduction of limb activity, and once the bone is loose, when you want to do the surgery, the effect of joint replacement surgery may be reduced.  Moreover, if the joint lesion is so severe that the entire joint becomes osteoarthritic and the joint is severely deformed, the surgery will be more difficult and complicated. Also, the leg may shorten and affect the walking gait, which will make the surgery more difficult.  In addition, if one side is in pain, the body will adjust and transfer some strength to the other side, which will increase the burden on the other limb and femoral head, then the original good joint may also have problems under such pressure.  In addition, femoral head necrosis may also affect the spine, because after this lesion occurs, it may cause shortening or pain, the waist will not be straight, but will be somewhat tilted, which may also have a negative impact on the spine in the long term.  It is also not good for the body to take painkillers, Chinese medicine or other related drugs for a long time.  Therefore, when the time comes to do the surgery but not to do it, there is actually a risk, only this risk is not concentrated in a period of time like doing surgery, but a long-term, slowly developing process.  Pain is a problem that many patients with osteonecrosis of the femur talk about.  So far, the cause of femoral head necrosis is not very clear; some people say that the early pain is caused by synovitis, that is, there is inflammation in the joint, and because of the stimulation of inflammatory factors, it will be particularly painful. Secondly, because the bone is affected by insufficient blood supply or other factors, it is damaged and its support is not enough, and microfractures may occur, leading to pain. What does microfracture mean? It means that the general structure of the bone appears to be fine, but the interior of the bone has collapsed. The pathological changes in the femoral head are actually collapse as well, and in the early stages when there is only collapse of the trabeculae inside the bone, it is called microfracture.  If these lesions can be controlled, it is possible to relieve the pain. Therefore, sometimes we use some anti-inflammatory drugs to make the synovial membrane less edematous, and the pain may be controlled; furthermore, by using some drugs to make the bone grow and supply blood better, when the bone’s tolerance is better, the pain will also be reduced; this can also do some surgery to preserve the femoral head, as if the house is about to collapse, after using a few pillars to hold it, the house will be supported to some extent, we Through surgery, we can use some materials to strengthen the support of the femoral head and possibly relieve the pain.  In addition, one point must be said, because painkillers are not for the treatment of femoral head necrosis, short-term use to relieve the pain is okay, if always rely on painkillers to relieve pain, is not desirable, because long-term painkillers will bring some adverse effects on the human body, including the digestive system, blood system, cardiovascular system and other aspects of the impact. The most fundamental thing is to keep the lesion of femoral head necrosis under control by other means.