Don’t believe in the myth of the sky – scientific and rational diagnosis and treatment of osteonecrosis of the femoral head. Osteonecrosis can affect bones and joints all over the body, but osteonecrosis of the femoral head is the most common and most dangerous. Femoral head necrosis is divided into two categories: traumatic and non-traumatic, the former is the aftermath of hip trauma, the latter is mainly caused by long-term use of corticosteroids (prednisone, dexamethasone, etc.) and long-term alcohol abuse in China. However, due to the characteristics of blood supply, most of the femoral head necrosis is difficult to repair completely on its own and needs to rely on the help of various treatments. Due to the different age of the patients, the different repair ability, the different necrosis area, and the different stages at diagnosis, there is no single treatment method that can cure all femoral head necrosis worldwide. To achieve good results, the key is to make early diagnosis (stage I and II) and to develop a scientific and individualized rational treatment plan according to the size of necrosis area, age, occupation and the cause of necrosis. Gao Fuqiang, Department of Bone and Joint Surgery, China-Japan Friendship Hospital For some years, newspapers, TV and radio stations have been flooded with advertisements about curing necrosis of the femoral head, and this world-wide unsolved problem seems to be solved overnight in China. These advertisements greatly mislead the majority of patients, causing them to suffer from pain as well as huge economic and mental losses, which is undoubtedly adding insult to injury. We sincerely advise patients and their families that myths must not be believed, and that science is needed to cure the disease. Ad I: Femoral head necrosis is a direct outward manifestation of damage to certain organs. We are not in favor of treating osteonecrosis of the femoral head as an orthopedic disease, and “treating the head when it hurts and treating the foot when it hurts”. Expert comment: Osteonecrosis can indeed affect many parts of the body, and we have seen a patient with as many as 19 osteonecrosis. However, the essence of the cause of osteonecrosis has not been clarified, and most of the systemic treatment at every turn is fanciful. Femoral head necrosis is an orthopedic disease, such as not according to the principles of orthopedic disease treatment is a target. Most of those so-called magic formulae are invalid. Advertisement two: “three regeneration therapy” using internal bone regeneration soup, external magnetic patch, auxiliary functional exercise exercises of the three in one treatment method, by the international orthopedic authority experts clinical verification: the total efficiency of the treatment of necrosis of the femoral head 96.5%, the cure rate of more than 85%, ranking first in the country similar drug therapy. Expert comment: Which international fracture authority experts will assert that simple medication, external dressing and functional exercise can cure osteonecrosis of the femoral head? The treatment of femoral head necrosis is divided into non-surgical treatment and surgical treatment, which should be determined according to the size of necrosis area and different stages. Non-surgical treatment includes effective Chinese and Western medicines, extracorporeal shock wave, magnetic therapy, etc. For stage II and III necrosis with larger necrosis area, surgical treatment is still needed, such as decompression, autologous stem cell transplantation, bone grafting, etc., supplemented by medication. Even so the current excellent efficacy of medium-term treatment still hovers at about 80%. Advertisement 3: Femoral rejuvenation soup has two forms of bone repair for femoral head necrosis: one way is intramembranous osteogenesis, which is direct osteogenesis, where capillaries grow into the dead bone area and produce osteoblasts, which produce bone around the necrotic trabeculae, and after calcification, new bone surrounds the necrotic trabeculae. Therefore, the bone density of the x-ray film increases continuously, and later the necrotic trabeculae are gradually absorbed, the femoral head trabeculae are shaped, and the hardness gradually increases until it returns to normal, so there is no worry of collapse. The other way is cartilage osteogenesis, which is the way the necrotic bone trabeculae are absorbed first, the cartilage cells produce cartilage, and then the cartilage calcifies and ossifies and gradually becomes hard, thus achieving healing. Expert commentary: This is a complete steal of the concept, moving the flowers. The human bone formation process is divided into two types: intra-membrane osteogenesis and cartilage osteogenesis, but the repair of osteonecrosis of the femoral head is crawling replacement, i.e. osteoblasts gather around the necrotic bone trabeculae to form new bone, and wrap around the necrotic bone trabeculae to make them gradually absorbed. Direct intramembranous osteogenesis and cartilage osteogenesis have not been found in the repair of femoral head necrosis. The mode of osteogenesis is sedimentary osteogenesis. Ad IV: For those with small necrosis in early stage, minimally invasive methods such as decompression implantation support and intervention with drug therapy can be used to improve the cure rate. For young and middle-aged patients in the middle and late stages, we have designed a series of surgical methods based on vascular bundle implantation, including bone flap grafting with vascular tips according to the different degrees of necrosis, which can better solve the two key problems of “ischemia” and “collapse” of the femoral head. Expert’s comment: Necrosis that is very small and far from the joint surface can be left untreated without sequelae. Interventional treatment of femoral head necrosis is completely misleading, it has neither theoretical basis nor practical effect. It is used in all countries of the world only in mainland China for the treatment of osteonecrosis of the femoral head, but the interventional technique is imported from the West and is not used in the West for the treatment of osteonecrosis. Autologous bone marrow stem cell transplantation has been successful in foreign countries. In China, China-Japan Friendship Hospital was the first one to carry out the transplantation. For young and middle-aged people (<50 years old) with small necrosis area (<30%) or unclear necrosis boundary, about 150ml of autologous bone marrow blood was extracted and bone marrow stromal cells were separated by cell separator and injected into the necrotic bone after drilling with fine needle under x-ray fluoroscopy. The key is to select suitable cases and have special equipment and techniques. In advanced osteonecrosis, the joint surface has collapsed and it is difficult to preserve the femoral head if the osteoarthritis is severe. It is an undisputed fact that a good quality artificial joint with proper placement technique can be used for more than 20 years. Advertisement 5: After 29 years of research and clinical practice, the group has successfully developed a large topical herbal ointment ...... "Guozheng Jianbao" which has overcome the three most persistent diseases in the medical field ...... osteonecrosis, osteonecrosis and osteomyelitis. Bone tuberculosis, osteomyelitis. It has filled the gap in the world medical field of external herbal ointment to cure orthopedic stubborn diseases. Expert comment: osteonecrosis is caused by ischemia, bone tuberculosis and osteomyelitis is caused by bacterial infection, these three diseases invade different parts of the pathogenesis and process are very different, a cream can cure the three major stubborn disease, is undoubtedly the sky is a nightmare, believe not. Advertisement six: four elephant wind chasing paste of drug ingredients is the use of nanotechnology in the supercritical low temperature state extraction, drug ingredients into small molecules, can be through the flesh coup deep to the bone disease site. Expert comment: playing with new scientific terms for fake drugs face gold is the usual trick in recent years. Nano is a unit of length, not a small molecule, which is completely unrelated to the wind. Even if this drug can treat necrosis of the femoral head, but to direct this drug from the skin to the necrotic bone, at least there should be a guide intermediary, currently attempting to direct chemotherapy drugs through the blood vessel injection to the tumor site is still under study. This cream can be directed into the bone, which is a miracle. Advertisement 7: Among the "five-linked therapy", the role of its medicinal bath in rehabilitation is irreplaceable by any therapeutic effect. Its unique diagnosis and treatment method technology and efficacy are in the leading position at home and abroad, and more than 40,000 patients have recovered from femoral head necrosis. Expert comment: As a means of rehabilitation, medical bath has certain efficacy in relieving pain symptoms, but the claim of "irreplaceable" is obviously an exaggeration. The so-called quadruplex and quintuplex are just playing with the concept. In clinical practice, it is very difficult to follow up 100 cases of treated patients, while some advertisements can easily cure 10,000 cases.