How should femoral head necrosis be staged and treated?

There are various clinical staging methods for femoral head necrosis, which can be divided into stage I, II, III and IV according to X-rays. In stage I, which is the very early stage of femoral head necrosis, non-surgical treatment is generally adopted, such as advising the patient to reduce weight, avoid climbing mountains and stairs, etc., and advising the patient to support crutches and walkers to reduce the weight of the affected limb. If the patient has bilateral osteonecrosis of the femoral head, he may be advised to use a wheelchair or be bedridden, etc. If the pain symptoms of femoral head necrosis are very obvious, you may consider taking some non-steroidal anti-inflammatory and analgesic drugs. For stage II or III ischemic necrosis of the femoral head, the surgical treatment is usually to preserve the patient’s own hip joint. At present, there are many kinds of surgical treatments to preserve the patient’s own hip joint internationally, such as drilling and decompression of the femoral head, removal of necrotic lesions and bone grafting, or bone grafting around the hip, or using fibula grafting. According to the latest international guidelines, anastomosis of the patient’s own fibula graft is considered to be the most effective of all treatment options. In patients with advanced femoral head necrosis, only artificial hip replacement surgery can be performed.