[Medical Q&A] If a diagnosis of femoral head necrosis is confirmed, does a hip replacement need to be performed?

Planner: Chinese Medical Association

Reviewer: Wang Jian, Chief Physician, Nanfang Hospital, Southern Medical University

Some patients always refuse to undergo hip replacement surgery. Some patients ask doctors to replace their joints as soon as they are diagnosed with femoral head necrosis. This is also unscientific. Hip replacement surgery replaces the original necrotic bones and joints with artificial joints, relieves the patient's pain factors, and improves joint function.

With the development of science and technology, the public has more ways to obtain health knowledge. Coupled with the popularization of physical examinations, many patients with femoral head necrosis are diagnosed in the early stages, when the lesions are not serious. Symptoms can be relieved and disease progression can be delayed through non-surgical treatments such as reducing weight, physical therapy, and drug therapy.

It is not necessary to replace the joint immediately after being diagnosed with femoral head necrosis. First, you need to understand the classification/staging. The doctor will make a comprehensive judgment on whether hip replacement is needed based on factors such as disease stage and age. Generally speaking, early-stage femoral head avascular necrosis mainly uses non-surgical treatment to delay the progression of the disease. If the disease progresses to the International Association for the Study of Circulation Osteotomy (ARCO) stage 2-3, drilling decompression or bone grafting for hip preservation can be considered. If the disease progresses to ARCO stage 4, hip replacement is often considered as a treatment option.