Femoral head necrosis is one of the common and difficult diseases in orthopedics today. There are 30 million patients with femoral head necrosis worldwide, and 4 million in China. Because of its high disability rate, it was once called the “undead cancer”. According to the survey, there are 150,000-200,000 new cases of femoral head necrosis in China every year, and a large part of them are due to long-term alcoholism. China is a country with a long alcohol culture, and drinking is not only a pastime, but sometimes a necessity. When friends and family get together during the New Year’s Eve, it seems that there is less of an atmosphere without a few glasses of wine. If you encounter a work function, not to drink a few glasses is not to say. As the saying goes, a little wine is good for the soul, a lot of wine hurts the body. If you drink too much for a long time, it will cause great harm to your body. Zhou Zhengxin, deputy director of the Department of Orthopedic Injuries at the First Affiliated Hospital of Anhui College of Traditional Chinese Medicine, said in an interview with reporters, “In the common perception, excessive drinking can lead to fatty liver, alcoholic cirrhosis, and even death. Few people know that it can also lead to ischemic necrosis of the femoral head. Therefore, people must pay attention to the moderation of alcohol consumption, so as not to cause disease.” Three common culprits of femoral head necrosis According to Zhou Zhengxin, alcoholics are a high incidence of femoral head necrosis, the more you drink, the longer you drink, the greater the chances of suffering from femoral head necrosis. Alcohol can also cause the body’s lipid metabolism to malfunction. Long-term alcohol drinkers have increased lipoproteins in their blood, the result of which triggers increased blood viscosity and vascular sclerosis, resulting in impaired microvascular blood flow to the femoral head. The alcohol-induced cystic lipid liver constantly releases fat emboli into the blood, which are so large that they have difficulty passing through the tiny blood vessels. Just like a cat cannot pass through a mouse hole, eventually these fat emboli stay in the blood vessels of the femoral head, causing ischemic necrosis due to the loss of nutrients in the femoral head. In addition, hormones and trauma are also one of the important factors leading to femoral head necrosis. Hormones are more and more widely used in clinical practice, and hormonal osteonecrosis of the femoral head is increasingly reported both at home and abroad. Femoral head necrosis is a recognized complication of hormones in wide application in recent years, and the incidence of hormonal femoral head necrosis has now surpassed that of femoral head necrosis due to trauma. Post-traumatic injuries such as fracture of the femoral neck causing a break in the nutrient vessels supplying the femoral head can also cause the femoral head to lose nutrients and become necrotic. Alcohol, hormones and trauma are the three most common culprits of femoral head necrosis. Signs of femoral head necrosis Femoral head necrosis, the onset of which often has a process. Therefore, timely medical attention can effectively stop the progression of the disease. However, Zhou Zhengxin reminded that the onset of femoral head necrosis is insidious and patients are often prone to ignore it themselves, and it is also easy to be misdiagnosed. Therefore, people who love alcohol, long-term use of hormones and people who have had trauma to the hip should pay attention to the signs of femoral head necrosis and be alert to it, so as not to let the condition of femoral head necrosis be delayed. Once the following symptoms appear, seek medical attention as soon as possible. Pain: The earliest symptom is pain in the hip or knee joint. Early ischemic necrosis of the femoral head can have no abnormalities, even taking x-rays is difficult to detect, and can only be determined through MRI. Claudication: Early patients may have intermittent claudication due to increased pressure inside the femoral head, which improves after rest. Late patients may have persistent claudication due to femoral head collapse and hip subluxation. Patients with osteoarthritis often have claudication due to pain and morning stiffness, and claudication is aggravated in late stages due to flexion, external rotation, and internal deformity. Restricted movement and joint stiffness: In the early stage, patients have normal or slight loss of hip movement, which is manifested as impaired movement in one direction, especially abduction and internal rotation. It should be detected by flexion, extension, adduction, abduction and internal rotation examination in the 90′ position of hip extension and hip flexion with knee flexion in the horizontal position and bilateral comparison. The range of motion gradually decreases with the development of the disease, and hip stiffness appears in the advanced stage. Prevention of Femoral Head Necrosis Chinese medicine has always advocated the treatment of untreated diseases, and femoral head necrosis is no exception, focusing on prevention and avoiding the development of femoral head necrosis. Therefore, Zhou Zhengxin suggests that prevention should mainly be done as follows: Avoid alcoholism: nine out of ten drinks are prone to necrosis of the femoral head. Although in daily life, “a thousand cups of wine with a confidant, a half-hearted conversation” and “rather hurt the body than hurt feelings” enliven the atmosphere of the drinking table and make people as drunk as possible, you must control yourself, drink as little as possible and never get drunk. Hormone therapy should be moderate: because hormone is also one of the important factors leading to femoral head necrosis, some information shows that the shortest glucocorticoid hormone such as dexamethasone has 7 days to lead to femoral head necrosis. Therefore, hormone therapy should be avoided as much as possible, except for patients who must apply hormones. For those patients who must use hormones, they should follow the principle of short course of treatment and appropriate dosage, and take Chinese herbal medicine at the same time to relieve the toxic side effects of hormones; if patients have pain in the hip or knee joint during the application of hormones, they should go to the hospital for examination. When a patient stops using hormones for two months after a period of application of high dose and short course of treatment, imaging should be performed. Once diagnosed with osteonecrosis of the femoral head, the patient should immediately undergo comprehensive treatment by bed rest, avoiding weight bearing and Chinese medicine. Don’t seek medical help in a hurry: many patients always hope to achieve the effect of treatment in a few days after the disease. Therefore, it is often easy to rush to the doctor, or take drugs at home by themselves. In this regard, Zhou Zhengxin suggested that patients should not be in a hurry when they encounter the disease, but must be under the guidance of doctors to regulate the use of drugs. In addition, patients with nailed femoral neck fractures must be guided by doctors to get out of bed and functional exercises. Different treatment methods for different periods Different treatment methods are used for different periods of femoral head necrosis. Femoral head necrosis, but the morphology has not changed, belongs to the early stage; if the deformation, loss of normal contour, or accompanied by bone spurs, it belongs to the late stage. Early stage can be treated without surgery including no weight-bearing, internal use of our Chinese herbal medicine osteoclastic capsule specialized in treating femoral head necrosis or with external application of Chinese herbal medicine eliminating stasis and jointing bone powder or combined with femoral head drilling and decompression. In the late stage, depending on the patient’s condition, age and requirements, either medication or implantation of bone flap with nutrition or artificial joint replacement may be used. It should be noted that the treatment of osteonecrosis should be accompanied by systematic medical treatment according to the liver function and blood rheology. In addition, in addition to absolute abstinence from alcohol, hormones should be used with caution in this disease. If hormones are needed for unavoidable reasons, it is important to explain the condition to the doctor to minimize the effect of hormones on osteonecrosis of the femoral head. Self-care for patients with femoral head necrosis Femoral head necrosis is not an incurable disease, and if patients can be detected and treated early, they can recover. However, Zhou Zhengxin reminded that due to the special nature of femoral head necrosis itself, treatment not only takes a long time, but also requires close cooperation from patients. It can even be said that self-conditioning is more important than taking medicine. Therefore, to recover early, patients should start from themselves to overcome the disease and recover as soon as possible. Be persistent: Patients should have a clear understanding of the disease and should not be pessimistic and disappointed and give up treatment, nor should they blindly seek medical help and follow advertisements all day long. At the same time, it should be understood that the course of femoral head necrosis is long and cannot be cured in one or two months. Some patients, after a period of treatment, symptoms relief, then interrupt the treatment, the result of the previous work abandoned. Pay attention to the warmth: life conditioning to the view is important. Patients must pay attention to keeping warm, because getting cold can slow down the local blood flow and can also cause changes in the internal pressure of the femoral head. In summer, don’t be cool and try to reduce the use of electric fans and air conditioners; in winter, don’t dress thinly because you love beauty. Normally, try to ride a bicycle, that is, you can avoid the weight-bearing pressure on the hip joint, but also make the function of the hip joint get exercise. Emphasize the functional exercise under non-weight-bearing conditions. Patients should not ride motorcycles as much as possible. When riding motorcycles, one of them will make both hips suffer from wind and cold, and the other is to make the hip joints not get the proper exercise. More calcium supplements: If the femoral head is hollowed out in the pat-down, you may want to take crutches, which can reduce the pressure on the femoral head. Diet, eat more milk, fish and shrimp, shellfish and other high-calcium food, it is best not to eat high-fat food. Wine is among the absolutely forbidden goods, to take advantage of the wine, any variety of wine can aggravate osteonecrosis, including white wine, red wine, beer, rice wine, medicinal wine. Regardless of the method, we must adhere to the systematic treatment, do not three days to fish, two days to sunbathe, generally speaking, the treatment of osteonecrosis of the femoral head after 1-3 years to basic stability.