The femoral head is commonly known as the upper end of the thigh bone – the hip bone shaft. Once necrosis occurs in the femoral head, which bears the weight of the whole body, it can cause unbearable pain and sleepless nights in the mild cases, and in the severe cases, it can lead to lifelong disability. This “cancer”, which is not difficult to diagnose but difficult to treat, has seriously affected people’s quality of life and ability to work, threatening people’s healthy life. What is Femoral Head Necrosis? Femoral head necrosis, known as aseptic necrosis of the femoral head or ischemic necrosis of the femoral head, is a lesion caused by localized poor blood flow to the femoral head for a variety of reasons, resulting in further ischemia, necrosis of bone cells, fracture of bone trabeculae and collapse of the femoral head. Since 1888, when the disease was first recognized by the world medical community, osteonecrosis of the femoral head has been transformed from an uncommon disease to a common and frequent disease. Especially since the introduction of hormones and their widespread use, the incidence of femoral head necrosis has gradually increased. In addition, the increase in the number of accidents after the change of transportation and the change of people’s lifestyle have led to a sharp increase in the number of patients with this disease. The latest survey shows that there is no significant gender difference in the occurrence of osteonecrosis of the femoral head, and that the disease can occur at any age, while those who have had hormone application, hip trauma, and severe alcohol abuse have a significantly higher chance of developing the disease. The first conscious symptom of osteonecrosis of the femoral head is pain around the hip joint, inner thigh, anterior side or knee. In the early stage, the pain starts as vague, dull or intermittent pain, which is aggravated by more activities and can be relieved or reduced by rest. However, there are some cases of persistent pain, whether it is from exertion or rest, or even from lying in bed. Moreover, the pain gradually increases. At this time, there is no obvious abnormal morphological change on the X-ray film, which gives the patient a wrong signal to relax, thinking that it is not a big deal, maybe it is the pain after the injury, and it may get better after some days, so he drinks alcohol and exerts himself as usual. However, the hip joint is already impaired to varying degrees. For example, the patient cannot extend the leg outward, cannot squat in place, limp, etc. At the advanced stage of femoral head necrosis, the femoral head collapses, shatters and deforms, and some can cause hip joint subluxation, at which time the pain will be reduced for a while, but the ensuing wear and tear makes it difficult to walk, and the pain of activity is aggravated, moving that is painful, and static that is not. How to self-examine to determine early femoral head necrosis 1, hip pain to the root of the thigh or the back of the hip, lateral and knee radiation. 2.Hip joint stiffness, weakness, restricted movement, inflexible leg lifting, early symptoms of cross-legged or outward skimming legs and squatting difficulties. 3, limp: that is, the affected limb does not dare to put weight on the road, like walking on tiptoe. 4.After the healing of fracture, dislocation or hip sprain, intermittent or persistent pain in the hip will appear gradually or suddenly. It increases after walking activities and also hurts when resting, and the pain is mostly pins and needles-like or sore. 5, long-term or short-term use of large amounts of hormones or frequent alcoholics appear hip pain, mostly hidden pain, dull pain, often located in the root of the thigh, obvious when moving, alleviated after rest. 6.When the weather is cold, the hip joint is sore and activity is limited. 7.When you have a cold and fever, the pain of the affected hip joint will increase. If the above-mentioned conditions occur, it is possible that the person has femoral head necrosis and needs to go to the hospital for MRI examination to confirm the diagnosis. How to treat femoral head necrosis There are many treatments for femoral head necrosis, and there are two main types of treatments, namely non-surgical treatment and surgical treatment. In general, patients suffering from osteonecrosis of the femoral head are more willing to undergo non-surgical treatment because they are afraid of surgery, especially they are willing to accept medication and ask around for treatment recipes, which gives the scammers an opportunity to take advantage of the situation, and in the end, they lose money and delay their condition. Although scientists and medical workers at home and abroad have been painstakingly researching the causes of femoral head necrosis and its pathogenesis for more than half a century, there are still many areas that are not very clear and need to be further explored. There are many current treatment methods, but each of them has its limitations. Because of this, the medical market and the streets are flooded with many new “package” methods, in fact, this reference itself is not scientific, some patients suffering from femoral head necrosis were deceived into accepting such treatment, the results are crying out for help, know that it is too late to be deceived. What should be the treatment for osteonecrosis of the femoral head? This is the main concern of all patients with necrosis of the femoral head. In fact, the choice of treatment cannot be based on one’s own subjective will, and the choice of treatment plan should be based on the patient’s age, necrosis site, necrosis area size and stage, and the individualized treatment plan should be developed by experienced specialists in order to achieve satisfactory results and maximize the savings in medical costs. According to the stage of femoral head necrosis. Early stage (stage I and early stage II) patients can receive non-surgical treatment, while patients with intermediate and late stage (late stage II and above) should receive surgical treatment, and some patients still need to receive other adjuvant treatments after surgery to obtain satisfactory results. So patients suffering from femoral head necrosis in the treatment, must get out of the misunderstanding, believe in science, depending on the severity of their condition to receive different treatments, otherwise it will miss the time of treatment, resulting in irreversible and serious results. Non-surgical treatment 1, drug therapy: drugs to improve local blood circulation: such as targeted prostaglandin E and Chuanxiongzin; anticoagulant drugs: such as low-molecular heparin; lipid-lowering drugs: such as statin lipid-lowering drugs; anti-osteoporosis drugs: such as sodium allantoin phosphate; other drugs: non-steroidal anti-inflammatory drugs – to relieve joint pain and other symptoms, to facilitate the restoration of joint function, to prevent the production of joint deformity;. Articular cartilage-protective drugs have the effect of repairing joint cartilage, protecting and delaying the destruction of joint cartilage. 2.High-frequency magnetic field: an adjunct to the treatment of early femoral head necrosis, which can improve microcirculation and promote the growth of blood vessels into the necrosis foci, and has a better effect on relieving pain symptoms. 3.Extracorporeal shock wave: used in the treatment of early femoral head necrosis, using its characteristic of causing microfracture to the sclerotic zone at the edge of the femoral head necrosis foci, eliminating the blocking effect of the sclerotic zone on the growth of blood vessels into the necrosis foci, thus promoting repair. 4.Hyperbaric oxygen: It is used to treat stage I and II early femoral head ischemic necrosis. Patients inhale 100% oxygen with a mask in a hyperbaric chamber for 90 minutes/day at 2-2.4 atmospheres, 6 times a week for a total of 100 treatments. 5, protective weight bearing: advocate patients to walk with double crutches, but do not advocate the use of wheelchairs, because disuse osteoporosis can occur. Swimming exercise has great benefits, without increasing the burden on the femoral head, and can prevent osteoporosis of the lower limbs. Surgical treatment to preserve the femoral head: For osteonecrosis has entered stage II late necrosis area greater than 30%, the efficacy of non-surgical treatment is not good, at this time should be taken to preserve the femoral head surgery, suitable for young and middle-aged patients, can be expected to achieve good results. 1.Autologous bone marrow stem cell transplantation: using X-ray fluoroscopy or navigation guidance to fine target multiple perforations in the osteonecrosis area, and injecting bone marrow stem cells under pressure into the decompression zone. 2.Decompression through the femoral head neck window, scraping of necrotic bone and compression implantation: this method is suitable for clear necrosis boundary, necrotic area near the joint surface, under X-ray guidance, scraping of necrotic bone and compression implantation of autologous bone and artificial bone. 3, lesion removal, with vascular fibula transplantation: applicable to early stage III and IV young patients, this procedure is slightly more traumatic and requires two incisions, but the cut fibula implanted with blood flow (live bone) and better mechanical support, so it is desirable for the femoral head that has begun to collapse. 4. Osteotomy: In some young patients, the necrotic foci are located in the weight-bearing area, while there is no osteonecrosis in the non-weight-bearing area, then the necrotic foci can be moved to the non-weight-bearing area by rotational osteotomy or internal and external osteotomy through the femoral ridge, while the normal cartilage surface is transferred to the weight-bearing area to protect the femoral head from collapse. The procedure to preserve the femoral head is done to avoid or delay the artificial joint replacement surgery. Because no matter how hard one tries, there will always be some patients with osteonecrosis of the femoral head who will eventually need artificial joint surgery, surgical treatment to preserve the femoral head should try to leave room for later artificial joint surgery. Currently, some medical units are keen on vascular intervention, which is actually harmful and unhelpful. Because according to the experience of cardiovascular and cerebrovascular embolism treatment, it is impossible to dissolve the embolized blood vessels after the diagnosis of femoral head necrosis has been established for a long time.