Femoral Head Necrosis Overview

Femoral head necrosis, also known as avascular necrosis of the femoral head, in some patients has a clear cause, including direct injury to bone blood vessels such as femoral neck fractures; direct damage to bone or bone marrow such as radiation injury or decompression sickness (also called caisson disease). However, the pathogenesis in many patients is not fully understood. Reduced perfusion leads to ischemia, followed by death of bone and bone marrow cells (bone marrow infarction), and ultimately loss of the mechanical properties of bone. This mechanism is common among most etiological theories. The process usually progresses gradually, leading to joint destruction over months to years.

Early symptoms are not typical, but the disease progresses rapidly. In advanced stages, severe outcomes such as femoral head collapse and hip joint dysfunction may occur. High-risk groups include chronic alcohol abusers, long-term steroid users, and those with prior hip trauma. In recent years, stem cell therapy, interventional treatment, and joint replacement have all advanced the comprehensive management of this disease.

Prevalence Worldwide

Femoral head necrosis occurs globally, with high attention in countries such as the United States, Germany, and Japan. In Southeast Asia, including China, India, and Vietnam, incidence is increasing yearly due to the high prevalence of underlying risk conditions.

Main Hazards

1. Hip Joint Dysfunction

Early symptoms are not obvious, but as necrosis expands, hip movement becomes progressively restricted, causing difficulty walking and significantly affecting daily life.

2. Persistent Pain

Chronic inflammation caused by necrotic tissue leads to persistent deep hip pain, worsening at night and not relieved even by bed rest.

3. Femoral Head Collapse and Deformation

Vascular impairment causes destruction of bone tissue structure, leading to femoral head collapse, joint misalignment, and eventual loss of weight-bearing ability.

4. Psychological and Economic Burden

Long-term pain and limited mobility bring great psychological stress to patients, while frequent medical visits, treatments, and rehabilitation costs also impose significant economic burdens on families.

Emerging Treatment Methods

Stem Cell Therapy

Stem cell therapy involves injecting bone marrow mesenchymal stem cells or adipose-derived stem cells into the necrotic area, stimulating new blood vessel formation and bone repair. This method shows significant efficacy in early and middle stages of femoral head necrosis.

① Promotes regeneration and repair of necrotic bone cells.

② Improves the local microcirculation environment and restores blood supply.

③ Slows down femoral head collapse progression, delaying the need for joint replacement.

④ Personalized procedure with minimal trauma and quick recovery.

Conventional Treatment Methods

1. Core Decompression

This procedure drills into the femoral head to reduce intraosseous pressure, improve local blood flow, and slow necrosis progression. It is often combined with bone grafting or stem cell injection to enhance efficacy.

2. Hip-Preserving Surgeries

Procedures such as autologous bone grafting or vascularized bone flap transfer are suitable for mid-stage patients without collapse, aiming to restore bone structure and preserve hip joint function.

3. Hip Joint Replacement

In advanced cases with severe collapse and loss of function, artificial hip replacement is an important means to restore quality of life, especially for elderly patients.

4. Medication Combined with Physical Therapy

Anti-resorptive drugs (such as bisphosphonates), vasodilators, and other medications can improve microcirculation. Combined with physiotherapy and rehabilitation training, they help slow disease progression.

5. Traditional Chinese Medicine (TCM) Comprehensive Therapy

Including herbal medicine, acupuncture, and massage, TCM can relieve pain, improve circulation, and help slow disease progression, serving as an adjunctive treatment for early-stage patients.

Conclusion

Femoral head necrosis is a progressive and serious disease. Without treatment, it can easily lead to lifelong disability. Experts at United Life International Medical Center emphasize the importance of early diagnosis and intervention. Proactive use of multimodal treatments, including stem cell therapy, can enhance treatment efficacy, slow disease progression, and help avoid the ultimate outcome of hip joint replacement.