Treatment of Femoral Head Necrosis

  1, non-surgical treatment: suitable for adolescent patients, for adults belonging to stage I and II, the scope of smaller can also be used this method. While removing the causative factors, strictly reduce or avoid weight-bearing and take more rest, physical therapy and oral anti-inflammatory and analgesic drugs are also feasible to reduce pain symptoms. X-rays should be taken regularly to check the progress of the lesion during the treatment.  2.Femoral head borehole decompression and bone grafting: Through the lateral hip incision, several small tunnels are bored in the femoral neck and femoral head to reduce the pressure in the femoral head. Avoid weight-bearing for 3 months after surgery, some patients can obtain a certain degree of symptom relief after surgery, but the medium and long-term results are not good, and the femoral head can still be collapsed and deformed.  3.Free fibula graft with vascular tip: It means that the fibula on the outside of one’s own lower leg is cut off together with its innervated blood vessels, and the fibula is implanted through the tunnel in the femoral head and femoral neck, and the blood vessels are anastomosed to provide blood transportation. It is indicated for young patients with ischemic necrosis of the femoral head. A period of avoidance of femoral head collapse can be obtained. The disadvantage is that it increases the trauma to the lower extremity, the surgery is traumatic, and the collapse and deformation of the femoral head cannot be completely avoided.  4.Transcondylar rotational osteotomy: The femoral neck is completely interrupted from its base, and the proximal end of the rotational osteotomy block is rotated so that the ischemic necrosis lesion of the femoral head leaves the weight-bearing area and makes the relatively normal part weight-bearing, and then the plate screws are fixed. It is suitable for patients with a small ischemic necrosis of the femoral head. The disadvantage is that there is a risk of non-healing at the osteotomy, no weight-bearing for 2-3 months after surgery, and the necrotic area cannot be completely prevented from collapsing, etc.  5.Hip fusion: It means that the cartilage in the hip joint is completely removed, and the bone and bone are fused together and fixed with plate screws. Due to the large functional deficiency of the hip joint after surgery and the risk of non-healing of the bone, it is rarely used now.  6.Tantalum rod implantation: A specially designed tantalum rod-shaped implant is inserted into the femoral head through the femoral neck to support the femoral head that is about to collapse, and is suitable for patients with good femoral head shape. A relatively intact appearance of the femoral head can be obtained for months to years. The disadvantage is that it is expensive and cannot prevent the femoral head from collapsing, making subsequent surgery more difficult, etc.  7.Artificial total hip arthroplasty: it is suitable for patients with ischemic necrosis of the femoral head whose conservative is ineffective and whose femoral head is collapsed. The surgical treatment is effective, complete relief can be obtained after the operation and good hip function can be preserved, and it has now become the main method of clinical treatment for femoral head necrosis. With mature technology, positive results and high success rate, this surgery is the gold standard of clinical treatment.