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.
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.
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。
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。
