Femoral head necrosis is an interruption or damage of blood supply in the femoral head, causing necrosis and repair of bone cells and bone marrow, which then leads to structural changes of the femoral head and causes collapse of the femoral head, manifesting as joint pain and limited movement function of the patient, and is one of the common and difficult to treat diseases in orthopedics. Causes of femoral head necrosis? Traumatic factors: 1. femoral neck fracture; 2. traumatic dislocation of hip joint; 3. femoral head fracture; etc. Non-traumatic factors: 1. long-term or massive application of glucocorticoids; 2. excessive alcohol consumption; 3. decompression sickness; etc. What are the symptoms of femoral head necrosis? Early stage: hip joint pain, pressure pain at or below the midpoint of the groin, painful percussion on the outside of the hip, restricted hip joint movement, occasionally accompanied by knee joint pain. Late stage: severe pain, difficulty in walking, muscle atrophy of the lower limbs, severe restriction of hip joint movement in all directions, painful and short limp. Staging of femoral head necrosis: Stage I (subchondral lysis stage): the femoral head is intact, the joint space is normal, and the subchondral bone of the femoral head has an arc-shaped transparent band, which constitutes the “crescent sign”. The diagnosis requires MRI. Stage II (femoral head repair phase): The femoral head is intact, the joint space is normal, and the subchondral bone density of the femoral head is increased, and a sclerotic zone of increased density is common. The diagnosis needs to be combined with X-rays and MRI. Stage III (femoral head collapse stage): the femoral head is partially collapsed and loses its round and smooth shape, the joint space remains normal. Stage IV (femoral head osteoarthritis stage): severe collapse of the weight-bearing area of the femoral head and flattening of the femoral head. The femoral head is displaced outward and upward, the joint space is narrowed, and there is often bone redundancy at the upper edge of the outer medullary socket. Is there any conservative treatment to cure osteonecrosis of the femoral head? If you are a young patient with early stage osteonecrosis and your symptoms are not very severe at the beginning, conservative treatment options are recommended first. First of all, you should stop drinking a lot of alcohol and stop using glucocorticoids; reduce weight-bearing walking as much as possible to reduce the load on the weight-bearing area of the femoral head to avoid microfractures and collapse of the weakened bone tissue; if the pain is obvious you can take allopathic pain medication. However, all these non-surgical treatments are only “symptomatic treatment” to temporarily relieve the pain, which is not “root treatment” and does not completely eradicate the cause of femoral head necrosis. There is no specific medicine that can cure this disease. If the patient has obvious short and long legs and walks with a limp, it is strongly recommended to use a high heel pad to keep the lower extremities equal in length, otherwise the limp in both lower extremities will lead to serious deformities of the lumbar spine, lumbar disc herniation and lumbar spinal stenosis. What are the surgical treatment methods for femoral head necrosis? For early stage (stage I/II) femoral head necrosis patients who have not yet collapsed, the following surgical methods can be used: simple core decompression, core decompression + bone graft, various types of osteotomy, etc. For patients with late stage (stage III/IV) femoral head necrosis who are on the verge of collapse or have collapsed and deformed, with long term pain and dysfunction, artificial hip replacement is feasible, which is a mature surgery with positive results and high success rate.