Speaking of hormonal ischemic necrosis of the femoral head, many people may be relatively unfamiliar. It refers to the death of the active components of the femoral skull (bone cells, bone marrow hematopoietic cells and fat cells) caused by the high dose of hormones. The pathological process is often accompanied by local or systemic progressive bone loss, especially the subchondral bone, which leads to the damage of articular cartilage.

　　Pietrograng and Mastomarine first in 1957 Reported a long-term massive glucocorticoid-induced ischemic necrosis of the femoral head. Some foreign scholars believe that non-traumatic osteonecrosis is caused by hormones in the first place. Domestic research also shows that adrenocortical hormone is the most common cause of necrosis of femoral head in Chinese.

　　 hormones have three effects on bone tissue cells:

　　①Directly acting on bone cells to inhibit the synthesis of their proteins and collagen, which in turn inhibits the growth of bone cells and the synthesis of mRNA, causing bone The trabecular structure is degeneratively changed.

　　②Reduce the secretion of sex hormones in the ovaries, testes and adrenal glands, reduce gastrointestinal calcium absorption, increase renal urinary calcium excretion, and cause secondary hyperparathyroidism.

　　③ Directly inhibit the activity of osteoblasts, reduce their turnover rate, shorten their lifespan, and directly stimulate osteoclast activity, increase bone tissue to PTH and 1,25-(OH)2-D3 In general, the osteogenic effect is weakened, the osteoclastic effect is enhanced, calcium salts are lost, osteoporosis occurs, and the bone tissue structure is degenerated.

　　 For patients with definite diagnosis, X-rays already have cystic changes or a wide range of lesions. Surgical treatment should be performed as soon as possible to prevent the collapse of the femoral head and affect the treatment effect. Screening for coagulation function in high-risk patients with hormonal ischemic necrosis of the femoral head, especially to determine the thrombophilia and fibrinolysis decline in such patients, may predict the occurrence of osteonecrosis.