Conservativetreatments for aseptic osteonecrosis of the femoral head have their ancestor inthe core decompression of the femoral neck， recommended by Ficat. Due toinconsistent results， this treatment has been optimized by either vascularizedfibular grafting， or by injecting autologous stem cells into the necrotic zone.The French promoters have published long-term results， showing efficacy in theearly stages of the disease， where the femoral head has not yet lost itssphericity. Over the last 10years， comparative studies， sometimes randomized，opposing them to simple core decompression， have been published bynon-promoters， confirming the possibility of stabilization or even regressionof necrosis area. But these techniques are not easy to implement. Cell therapyrequires treatment of marrow samples by centrifugation to obtain a pellet witha high concentration of haematopoietic cells. The now proven long-term efficacyas well as the safety of this technique make it the method of choice fortreating young patients detected at the sub-radiological stage by MRI.Unfortunately， many are seen late with detached cephalic cartilage or collapsedfemoral head and have no other option than total hip arthroplasty. Thistechnique is very reliable. With alumina ceramics， results of more than 20yearsshow the absence of wear and osteolysis， although other complications such asinstability or periprosthetic fractures may occur in these young and activepatients.
问：什么是股骨头坏死？答：股骨头坏死是由于股骨头内微循环障碍所引起的一系列股骨头骨细胞死亡、无菌性炎症、股骨头结构改变等病理变化，最终常发展为软骨下骨坏死和塌陷。由于股骨头坏死发病机制复杂且尚不明确，因此是骨科常见的难治性疾病。问：股骨头坏死如何分类？
一张方扶正祛邪，直击核心;从医多年，经常听到股骨头坏死的患者这样说:我这病没法治了，以后肯定要坐轮椅，吃点止疼药维持吧，不折腾了。以我接诊的一位患者为例，张某，男，45 岁，2023 年 5 月 12 日初诊。
【导读】股骨头坏死是一种常见的骨关节病，又称股骨头缺血性坏死。那么，什么样的人容易得股骨头坏死呢？它又分为几个阶段呢？哪个阶段比较严重呢？股骨头坏死通常分为创伤性股骨头坏死和非创伤性股骨头坏死，后者又称为股骨头无菌性坏死或股骨头缺血性坏死。
髋关节股骨头坏死的治疗是要量身定做的，这种病可由多种因素引起，包括外伤、髋关节手术、皮质类固醇，酗酒，系统性红斑狼疮，镰状细胞病和凝血障碍等，因此没有单一的和标准化的治疗方法，但治疗原则还是以能保守尽量保守，不得已再做手术为主。
来源：陕西日报股骨头坏死是骨科最为常见的病症之一，也是世界骨科领域三大疑难病症之一。股骨头坏死主要是由于骨细胞死亡，造成了股骨头力学结构以及股骨头骨质破坏，最终会导致股骨头塌陷，造成关节活动受限，甚至丧失劳动能力。
Lyu J ， Ma T ， Huang X ， et al. Core decompression with β-tri-calcium phosphate grafts in combination with platelet-rich plasma for the treatment of avascular necrosis of femoral head. BMC Musculoskeletal Disorders， 2023， 24:1-8.
股骨头坏死是一种让人闻之色变的疾病，也被称为“不死的癌症”。对于股骨头坏死的患者来说，是不是只能进行人工髋关节置换呢？答案是否定的。长沙市第四医院骨科一病区（关节、骨病、运动医学科）近日就用微创手术为左侧股骨头坏死的肖先生进行了保髋手术治疗。
股骨头坏死，又称股骨头缺血性坏死，是一种顽固性、进展性疾病，病程长，好发于青壮年，致残率极高。疾病特点主要表现为股骨头软骨下骨区域供血不足导致骨细胞和骨髓坏死，自身无法修复，最终导致股骨头塌陷形成骨关节炎。
