For the treatment of advanced hormone-induced ischemic necrosis of the femoral head, many patients would like to know, at this time, the lesion of the femoral head is already very serious, no matter what means of total hip replacement will be inevitable, but if If the patient is too young or limited by medical conditions, the following surgical methods can be considered.

　　1, dead bone scraping Plus bone grafting: It is suitable for young and middle-aged patients who have not yet collapsed or slightly collapsed. The femoral head with slight collapse can be managed to reset and replant bone after the dead bone is scraped off. The bone graft material can be selected from autogenous bone, and the application of certain cytokines such as bone morphogenetic protein can also be considered. The autologous bone is usually selected from the fibula or iliac bone, and it is generally believed that the vascularized bone graft is reliable. Recently, some scholars have reported that the use of vascularized fibula grafts to treat avascular necrosis of the femoral head that has collapsed but has not yet formed osteoarthritis. ~ 12 years (average 4.3 years) of follow-up, also achieved good results.

　　2. Osteotomy: Sugioka described the treatment of femoral head necrosis by trochanter osteotomy in 1978. This surgical method can prevent the progressive collapse of the articular surface of the femoral head and can improve the collapse of the femoral head. Inconsistent head acetabulum. The principle is to rotate the femoral head and femoral neck forward along its longitudinal axis, so that the non-necrotic area of the posterior face of the femoral head rotates to the weight-bearing area, and the necrotic area to the non-weight-bearing area.

　　3. As for which operation method is more ideal than osteotomy, Hasegawa has followed up the patients with the two methods for 5 years and 10 years after operation, and thinks the effect is similar; and Some scholars believe that osteotomy is more effective in restoring joint function and delaying the process of collapse. At the same time, if the operation fails, the prosthesis replacement method can be used instead.

　　4. Total hip replacement: It is suitable for patients with advanced femoral head necrosis, a wide range, and older patients. Therefore, it is necessary to consider whether the prosthesis will be affected in the early stage of avascular necrosis of the femoral head Replacement surgery, simple replacement of femoral head or femoral head surface prosthesis is no longer advocated, and it is generally advocated to perform total hip replacement. The latest literature reports that the long-term effect of total hip arthroplasty after hormonal avascular necrosis of the femoral head is not as good as other types of femoral head necrosis, and whether the use of bone cemented hips or non-cemented hips has no postoperative follow-up Significant differences.

　　 Prognosis and prevention: The prognosis of hormonal ischemic necrosis of the femoral head is not ideal. Once it occurs, there is no way to completely reverse its pathological changes. In the end, total hip replacement is required, so the best The method is prevention. Be careful not to abuse adrenocortical hormone drugs; if some diseases must use hormones, you must master the principle of short-term and appropriate amount. After using hormones, it is necessary to cooperate with the application of vasodilator drugs, vitamin D, calcium preparations and Chinese medicine for promoting blood circulation and removing blood stasis. Patients taking hormones should check in time if they have hip discomfort.