Is it necessary to have replacement surgery for stage 3 femoral head necrosis?

If you are still young, you can recommend being conservative**!

At present, there are many methods of traditional Chinese and Western medicine for femoral head necrosis, each with its own advantages and disadvantages. At present, there is a global consensus among doctors that there is no best way to reverse large-scale femoral head necrosis, and the following is a list of feasible methods for reference.

1. Drilling decompression: Some people call osteonecrosis intraosseous hypertension, so there is drilling decompression, which is currently the most common method used by doctors around the world before the collapse of the femoral head, with an effective rate of about 80%. It is mainly indicated for patients before early collapse.

2. Total Hip Replacement: Total hip replacement surgery has been hailed as one of the greatest surgical advances of the 20th century. This method is the most effective after collapse, with a wide range of indications and good results, and has become the gold standard for late femoral head necrosis.

1) Age limit: In the past, considering the wear resistance of the material, it was mostly used for people over 50 years old, but with the improvement of materials, such as the emergence of prostheses with metal-to-metal, metal-to-ceramic, and ceramic-to-ceramic friction interfaces, there is no age limit, and even 20 years old can consider joint replacement surgery (but it must be a large medical center with the above-mentioned improved prosthesis), and it has been used for 40 years.

3) "Young people can't do this surgery" This is a misleading view, it is the previous view, the current metal-to-metal, metal-to-ceramic, and ceramic-to-ceramic friction interface prostheses can generally be used for more than 20-30 years, and after this time, most of them can still be used.

4) Complications: postoperative pain, limited movement, acetabular abrasion, prosthesis rupture, prosthesis infection, fat embolism, pulmonary embolism, etc. However, the incidence of this disease is not enough in large joint replacement centers, but it may be as high as 10% in informal small hospitals, and once it occurs, the consequences are serious.

Therefore, the key is to seek medical treatment in a regular hospital.

3. Intervention: It is to inject the drug directly into the arteries and blood vessels, and this method is also an indirect method, which dissolves the embolization through the drug to achieve the curative effect; But there are also many drawbacks, which are basically not used.

4. Vascular transplantation: the nearby blood vessels are bundled together and implanted into the necrotic area, and the clinical practice is only preoperative imaging, without postoperative examination; It is rarely used now.

5. Vascular pedicle bone flap transplantation: transplant the quadratus femoris femoral valve or internal circumflex iliac artery bone flap to the osteonecrosis area, which is clinically verified and the effect is acceptable, but it has great limitations and is traumatic, so it is not used much.

In addition, there are still some patients in China who use traditional Chinese medicine**, and its efficacy is exaggerated, because so far, there is no SCI ** to prove that it is **effective, which is comfort**, such as:

1. External traction and internal administration: It may have an effect on the relief of pain, but it cannot delay the development of osteonecrosis.

2. Massage, acupuncture, physiotherapy, fumigation, assistance**.

3. Functional exercise: reasonable and reasonable appropriate exercise.

No, you don't. Plasters, pills can be good for 9 months, and the film is verified.

Replacement is not recommended in the middle stage of femoral head necrosis. Conservative** is recommended.

Femoral head necrosis is a disease that gradually worsens, and must be carried out as soon as possible after detection** to avoid aggravation of the condition due to delay.

At the same time, it is necessary to avoid weight-bearing, use crutches well, and reduce weight-bearing.

Hello, this needs to be decided according to your specific situation. In general, the lesion can be curetted and the autologous iliac bone graft can be implanted with tantalum rod implantation in the middle stage, and total hip replacement surgery can be considered in the late stage.

Be sure to pay attention to what you eat in your daily life:

Clause. 1. Supplement foods rich in calcium and phosphorus, such as milk.

Clause. 2. Patients with femoral head necrosis should be persuaded to abstain from drinking, even if it is not due to the necrosis of the femoral head caused by drinking. Because alcohol is also one of the causes of necrosis of the femoral head.

Clause. 3. Patients should have a reasonable diet and a balanced diet.

Clause. Fourth, hormonal femoral head necrosis can take more vitamin C.

Clause. 5. Avoid spicy food, so as not to affect the efficacy of the medicine.

Be sure to follow the doctor's instructions to take the correct ** method, and remember not to treat it randomly.

According to your description, you now have developed femoral head necrosis to the middle stage, it is recommended that you do an MRI examination, in general, the early and middle stage can be used to curettage and autologous iliac bone graft tantalum rod implantation surgery, late stage can consider total hip replacement surgery, there is currently no good drug for femoral head necrosis**.

Femoral head necrosis is based on the patient's condition to decide whether joint replacement is needed, generally for early stage zero and stage 1 femoral head necrosis, because it is reversible, can be carried out in time**, if the time is delayed, joint replacement is generally required in the middle and late stages.

Early diagnosis and early diagnosis are particularly important to prevent femoral head collapse and patient disability, and for early to mid-femoral head avascular necrosis, the ideal method should be hip preservation rather than replacement of artificial joints.

As for whether patients in the middle and advanced stages can keep their hips, it depends on these factors:

First, the age of the patient. If you are too young, hip preservation is recommended in patients with little impact on their lives in the middle and advanced stages**.

Second, it is the patient's symptoms, whether you are stage 3 or stage 4, if your symptoms are not so obvious, the limited movement of the joints is also okay, not so severe. At this time, hip preservation can also be taken**.

There is also a group of patients, even after the age of 65, the age has reached a standard for hip replacement, at this time, if the patient has other underlying diseases, that is, can not tolerate artificial joint replacement, this category of patients can also do hip preservation**.

Therefore, whether to keep or change depends on the patient's own situation.

Hello, judging by the situation you described and the symptoms you manifested. Under normal circumstances, if the femoral head has reached stage 4 and the bone collapses and deforms, it is necessary to have surgery to replace the femoral head. Conservative ** is ineffective. The results of femoral head replacement surgery are also very good.

In the middle stage of femoral head necrosis, the autologous iliac bone graft can be implanted with tantalum rod implantation, and in the late stage, total hip replacement surgery can be considered.

In fact, many Western doctors are bad doctors, and in some places, in order to pursue profits, they may slightly exaggerate the occurrence of some diseases, so you can turn a few more to take a look, and you can also consult Chinese medicine to see if there is a good way.

It is recommended not to do replacement surgery easily, you can be conservative for a period of time, I was also asked by the doctor to change it directly, but I hesitated at that time, and went to several hospitals, all of which recommended that I take medicine first to see if I can control it. Later, I took Henggu Bone Wound Healing Agent at the pharmacy, and now I have been taking it for half a year, and the control is very good, as long as I don't bear weight, the pain is not obvious. Welcome, I ask for a big thumbs up.

Suggestion: The success of artificial femoral head replacement is directly related to the technical level of the hospital and the patient's age, bone condition and physical fitness. Moreover, the high cost of surgery, the high risk of the surgical process, and the incomparable advantages of artificial materials for the human femoral head, which are also the main reasons why many patients are reluctant to choose artificial femoral head replacement.

Artificial hip replacement includes artificial femoral head replacement and artificial total hip replacement (i.e., both femoral head and acetabular replacement). To put it simply, it is a surgery that replaces the patient's original material with an artificial material.

Artificial femoral head replacement is suitable for patients over 65 years old with severe femoral head necrosis, and the surgical risk is high, the cost is high, and there are a series of complications after surgery, so many patients are discouraged.

The effect of artificial femoral head replacement is rapid, but there are problems of blind expansion of surgical indications and non-standard operation techniques in China.

Artificial joints have a certain service life, generally 10 years, therefore, the state clearly stipulates that artificial femoral head replacement is only suitable for patients over 65 years old with severe femoral head necrosis. Many patients with osteoporosis often have various complications such as prosthesis loosening, joint infection, and artificial femoral head dislocation 2-3 years after surgery, which undoubtedly increases the pain and economic burden for patients. No one wants to spend the last few decades of their lives in bed and unable to take care of themselves, so we do not recommend surgery for younger patients.

Hello, almost all patients with femoral head necrosis can eventually obtain joint function through replacement, and the risk of replacement surgery itself is relatively low. However, there are inevitably risks in surgery, and complications such as anesthesia accidents, nerve damage, and dislocation may also occur during artificial replacement surgery, and for some elderly people and patients with high blood pressure, there may also be problems such as surgical intolerance.

After the replacement of the femoral head necrosis, the patient's care plays an important role in the disease. Avascular necrosis of the femoral head caused by the trauma caused by surgery, causing inflammation and congestion and edema around the hip joint, reaching the peak in two days, and then entering the absorption stage of inflammation, edema and hematoma, this stage can vary depending on the size of the wound, the presence or absence of hematoma residue, the liquefaction of fat, the presence of infection and age, and the condition of the wound, generally about one month.

In the early postoperative stage, it is anti-infection, unobstructed drainage, elimination of hematoma, promotion of wound healing, and attention to the body's righting. After the suture is removed, it is important to further promote the absorption of local inflammation and edema and prevent and reduce adhesions around the joint, and at this time, the internal and external combination of blood circulation and blood stasis is emphasized. External treatment focuses on the external application of plasters, physiotherapy, massage, sitting-lying exercises under the bone (pelvic osteotomy, with the exception of capping) or passive leg lifting and hip flexion to prevent joint adhesions.

After one month**, the local tissues were soft, the hip flexion function gradually recovered, and the pain was reduced.

In addition, during the nursing period, it is necessary to follow the doctor's instructions and do not rush to achieve results, so as to reduce the probability of prosthetic complications.

Here are some of the disadvantages of replacement surgery:

First, the cost is high, the risk is high, and the trauma is large.

Second, the replacement of the femoral head has a high technical content, and a slight deviation in the position is easy to cause pain and even lifelong disability. Clause.

3. Even if the maximum service life of the artificial hip joint imported from abroad is only 10-15 years, the service life of the domestic artificial hip joint is only 5-6 years, and the operation needs to be performed again when the service life is reached. Therefore, in general, patients under the age of 60 are not recommended for surgical replacement. Hope this helps!

The main disadvantage of replacement is secondary replacement, which is not recommended for young patients, and it is best to delay conservatively for a period of time and wait until after the age of 55 before undergoing replacement. If it doesn't seriously affect your life, such as not being able to take care of yourself, then it's better to do it, after all, the quality of life is still very important.

Femoral head replacement is still conservative first**, your age is too young, although girls love beauty and pay attention to their own image, because of age, it is still not recommended that you have replacement surgery.

You also didn't explain what is going on with your femoral head, is there a collapse? Is it serious? If the collapse is severe, it will have to be replaced.

You can find more information about joint replacement, or go to the place where the femoral head is necrosis in the specialist** for consultation. I found an article on femoral head replacement that I hope will be helpful to you.