What is femoral head necrosis?

1. How did the femoral head necrosis come about

A: There are three main reasons for femoral head necrosis: First, it is caused by hormone drugs. That is, before the patient got femoral head necrosis, he used a lot of hormone drugs, such as cortisone, prednisone, dexamethasone and so on. After three months, half a year or a year, he developed hip pain, which means he got femoral head necrosis. The second is traumatic necrosis of femoral head. That is, it is caused by hip fracture, dislocation and sprain and contusion; Third, a large number of alcoholism caused femoral head necrosis. In addition, there are a few hip dysplasia, hematological diseases, Kaschin-Beck disease, hypertension and radiation sickness, which can also cause femoral head necrosis.

2. What factors are related to avascular necrosis of femoral head

At present, the etiology of avascular necrosis of femoral head is not very clear, and the factors causing avascular necrosis of femoral head can be summarized into two categories: traumatic and non-traumatic. Trauma includes femoral neck fracture, dislocation of hip joint and other injuries around hip joint. There are many non-traumatic factors, mainly long-term or large-scale use of hormones and alcoholism.

Third, how long does it take to drink alcohol to cause avascular necrosis of the femoral head

According to the statistics of more than 3 patients. Drinking half a catty of liquor every day may lead to femoral head necrosis in about 1 years, and drinking 1 catty of liquor every day may lead to femoral head necrosis in about 5 years. This is one of the main reasons for the obvious increase of avascular necrosis of femoral head in recent years.

fourth, what are the symptoms after getting femoral head necrosis?

a: after suffering from femoral head necrosis, it is characterized by pain in the front and back of the hip root at the initial stage, especially the pain in the inner thigh root. At first, it is intermittent pain, and then it is persistent pain. When the activity increases, the pain gets worse, and it will be relieved after rest. The second is the dysfunction of hip joint activity. Such as extension, flexion, abduction, adduction and rotation. Can't get on the "Erlang legs", can't get on the legs, and then walk limping, thigh muscle atrophy, can't squat and other symptoms.

5. Why does the femoral head necrosis limp

Lameness is one of the main clinical manifestations of femoral head necrosis. There are three main causes of claudication: pain, limited function and shortened limbs. When the affected limb is in pain, the affected foot will lift up quickly as soon as it steps on the ground, while the healthy foot will fall on the ground for a long time, so that it will limp when it is fast and slow. The functional limitation caused by femoral head necrosis is mainly manifested in the spasm of adductor muscle of hip joint, and the hip joint often appears flexion adduction deformity, which can not be straightened and abduction, forming a relatively long and short, and limping. In patients with femoral head necrosis, the femoral head collapsed in the later stage, which led to the shortening of the affected limb, exceeding 1 cm, forming an absolute long and short, and limping. If claudication is caused by pain or limited function, claudication will disappear naturally after the pain disappears and the muscle spasm is relieved. If claudication is caused by collapse of femoral head, it will be accompanied by life. This is also one of the reasons why patients with avascular necrosis of the femoral head need crutches.

VI. Why does osteonecrosis easily occur in the femoral head

Osteonecrosis can occur in any part of the human body. Only 4 ischemic necrosis has been found, and the incidence of femoral head necrosis is the highest, which is mainly determined by biomechanical and anatomical characteristics. (1) heavy load. Hip joint is the largest joint of human body, which supports the weight of the whole upper body, and the weight-bearing area only accounts for 1/4 of the femoral head. The pressure between the head and the mortar is relatively high. Maintaining this pressure for a long time will not only easily cause damage to the bone structure, but also affect the local blood circulation. (2) the shear force is large. The hip joint is different from other weight-bearing joints in that the line of force between the two bones is vertical, and an angle of 132 degrees is formed between the femoral shaft and the femoral head and neck. The gravity of the trunk moves from acetabulum to the femoral shaft through the femoral head and neck, and the line of force is not vertical, resulting in shear force. Therefore, the physiological pressure on the head and neck is much greater than that on other joints. (3) the range of activities is large. The range of motion of hip joint is second only to shoulder joint, such as flexion, extension, abduction, adduction and rotation. The range of activities is large, and there are more opportunities for injury. (4) Less blood supply. The blood supply of the femoral head mainly depends on the lateral retinaculum and the medial retinaculum arteries from the arterial ring outside the capsule, and the anastomotic branches of the blood vessels are few and weak. When one blood vessel is blocked and the other can not be compensated in time, it will cause blood supply disorder of the femoral head, and the bone tissue of the femoral head will lose blood supply, thus forming ischemic necrosis.

VII. Why are there more and more avascular necrosis of the femoral head recently

The incidence of avascular necrosis of the femoral head has obviously increased in recent years. The main reasons are as follows: (1) hormone abuse. One is the abuse of hormones in the treatment of other diseases in hospitals, and the other is the abuse of hormones in food in daily life, such as meat chicken, pork, fruits and vegetables, which makes the accumulation of hormones in the human body gradually increase. If there are other inducements, it can cause femoral head necrosis. (2) drinking. With the improvement of people's living conditions and the increasing number of alcoholics, the number of patients with femoral head necrosis has increased. (3) trauma. With the development of transportation and construction, the number of trauma patients and patients with femoral head necrosis has increased.

VIII. Why do some patients have long limbs

Generally, patients with avascular necrosis of the femoral head are prone to collapse of the femoral head, narrowing of the joint space and shortening of the affected limbs, but some patients have long limbs after a period of treatment, causing psychological panic. In fact, the length of the affected limb is an illusion, not that the real length of the affected limb has increased, but because of the long-term pain of the hip, the uncoordinated state of the lumbar muscles, the imbalance of muscle tension and contraction force, which makes the pelvis tilt and presents the illusion of the length of the affected limb, and the actual length of both lower limbs is still equal or shorter. When this happens, there is no need for special treatment. When the affected limb falls to the ground and bears weight, with the exercise of the waist muscles, the pelvis will slowly return to the normal position and the length of the lower limbs will be balanced.

IX. Why do some patients' pain ease and others get worse during the treatment

After systematic treatment, most patients with femoral head necrosis have improved their clinical symptoms and signs, but some patients complain that their hip pain has improved. According to clinical observation, the law of pain is aggravation, alleviation, aggravation and alleviation, and the degree and time of aggravation gradually decrease until the pain disappears. In fact, the incomplete pain of hip joint indicates the aggravation of the disease, and this phenomenon will also occur in the process of bone repair. Necrotic bone is absorbed near the articular surface, resulting in decomposition products of lipids and proteins. These toxins enter the articular cavity to stimulate synovium, resulting in severe pain, complete absorption of dead bone, and the pain gradually decreases until it disappears, which is more common in patients with steroid-induced femoral head necrosis. Therefore, it's normal for the pain to increase temporarily during the treatment. Please don't panic.

X. Why do patients with femoral head necrosis suffer from knee pain

Femoral head necrosis is mainly characterized by limited hip joint function and tenderness at the middle point of the groin, while some patients suffer from pain in the lower and inner knees and thighs, mainly due to nerve conduction. There are two groups of nerves around the hip joint, the femoral nerve in front and the obturator nerve inside. The femoral nerve comes from waist 2-waist 4, and it is a big branch of the lumbar plexus. It goes down between psoas major and iliopsoas muscle, runs under the inguinal ligament, and shares in the triangle outside the femoral artery, and then branches off to dominate quadriceps femoris, sartorius muscle and the skin in front of the thigh. Obturator nerve originates from waist 2-waist 4, exits the inner side of thigh root, and divides into muscle branch and skin branch. Muscle branches mainly dominate adductor muscles of thigh, and cutaneous branches are mainly distributed in the lower skin of inner thigh. Because the femoral nerve and obturator nerve dominate both the hip joint and the knee joint at the same time, when the hip joint is diseased, it can stimulate the nerve and cause pain in the inner thigh and knee through reflection.

Xi. How to treat the femoral head necrosis?

a: there are two aspects of treatment. One is non-surgical treatment. That is, the combination of traditional Chinese and western medicine, oral administration of traditional Chinese medicine, external application of plaster, functional exercise, physical therapy, etc., has a good effect and is easily accepted by patients; The second is surgical treatment. Including surgical drilling and fenestration decompression, bone grafting and replacement of artificial femoral head, the effect is not ideal, and most patients are unwilling to accept it.

12. Can femoral head necrosis return to its original normal spherical shape after conservative treatment?

It depends on the stage of femoral head necrosis. If the femoral head has not collapsed in the early and middle stages of necrosis, the pathological process of its progress can be terminated after effective conservative treatment, and the original spherical state can still be maintained. If the femoral head collapses in the later stage, it is impossible for adults to restore its original spherical surface. However, the aspheric surface on X-ray film is not consistent with the function of hip joint. Most of the femoral heads, which are not only round, have basically reached normal function after being cured.

XIII. What are the functions of traditional Chinese medicine treatment?

A: It mainly promotes blood circulation to remove blood stasis, dredge blood vessels, relieve spasm and pain, strengthen bones and marrow, strengthen bones and muscles, etc., so as to relieve pain in the affected part, make necrotic bones fall off and absorb, and then grow new bones. But it can't grow to be the same as before.

XIV. How to judge the therapeutic effect

A: It mainly depends on the elimination of symptoms, such as pain relief or no pain, followed by functional recovery. Such as hip joint dare to move, not limping, etc. X-ray changes are not the main ones. Because no matter how you treat it, the femoral head will not grow into the original good-legged femoral head. Therefore, don't say that it is not good after watching the film. The main symptoms are eliminated, the function is restored, the life can take care of itself or the ability to work is restored, and the purpose of treatment is achieved.

XV. Why do you want to do functional exercise?

A: After the necrosis of the femoral head, the muscles of the affected limb atrophy, and the joint capsule and ligament contracture and stiffness occur, resulting in limited joint activity. Therefore, while treating the femur, we should strengthen functional exercise to prevent and alleviate the above changes in these soft tissues and create conditions for restoring joint function. If drug therapy accounts for 1/2 and exercise accounts for 1/2, don't ignore functional exercise and do it according to the requirements of exercise (video tape).

XVI. Can heavy physical labor be carried out after the femoral head necrosis is cured?

Whether the acquired treatment of femoral head necrosis is conservative or surgical treatment is bound to go through the process of absorption of dead bone, growth and shaping of new bone. After treatment, the bone density in the necrotic area of the femoral head increased and then became clear, and the trabeculae were arranged neatly, which was basically the same as that of the normal femoral head after shaping. It can be seen that it has normal physiological function, and can bear the same pressure as normal femoral head to carry out normal activities, but it is forbidden to use too much force during activities to prevent ischemic necrosis of femoral head caused by recurrent sprain and contusion and blood circulation disorder of hip.

XVII. How to protect yourself from femoral head necrosis when the weather changes

Most patients with femoral head necrosis prefer warmth and fear cold. When the weather gets cold, their condition gets worse and their hip pain is unbearable. The main reasons are humidity and cold. Humidity can cause skin respiratory and metabolic dysfunction in buttocks, legs and other places, resulting in slow blood flow in local tissues, which leads to increased microvascular congestion, blood stasis and exudation, and aggravates patients' symptoms. Therefore, under humid conditions, patients should keep their working and living environment dry in addition to proper activities to avoid aggravation of symptoms. Cold mainly causes blood circulation disorders such as blood stasis, ischemia and edema in the hip through vasoconstriction of the hip and leg, which aggravates the patient's condition. Therefore, you should not sit or sleep in a cold place, and pay attention to more activities and keep warm in winter.

XVIII. Why do patients with convenient walking need crutches

Many patients with femoral head necrosis think that crutches are needed only when they can't walk, which is wrong. Because although the film shows that the femoral head has not collapsed, there have been fundamental changes inside the femoral head. Its strength under pressure has obviously decreased, but X-rays can't show it. At this time, once the pressure exceeds the bearing strength of the femoral head, it will collapse. After the collapse, the treatment time is prolonged, the cost is increased, and there are some sequelae after the cure. Therefore, patients with convenient walking should also be on crutches, which is very beneficial for future recovery.

XIX. Should patients with femoral head necrosis stay in bed during treatment

Many patients think that patients with femoral head necrosis can't bear the burden, which means staying in bed. This idea is wrong. The formation of femoral head necrosis is ischemia caused by various reasons. After the formation of necrosis, the movement is restricted due to pain and other reasons, resulting in a series of changes such as decreased muscle contractility and joint movement disorder. On this basis, the activity is reduced, thus forming a vicious circle, which eventually leads to local blood circulation disorder and necrosis continues to develop. From this point of view, the idea of inactivity after illness is wrong. Exercise can not only improve blood circulation, but also prevent the occurrence of complications, which is conducive to the repair of femoral head. However, when functional activities are carried out under the premise of no load, the radiation should not be too large, the force should not be too strong, and each movement can achieve a slight pain, so as to get twice the result with half the effort.

2. Why do you take medicine and apply medicine to treat femoral head necrosis?

A: Femoral head necrosis is a systemic and local disease. Therefore, it is necessary to combine systemic therapy with local therapy, internal therapy with external therapy, and physical therapy with medication. Internal medicine can cure the root cause, and external medicine can cure the symptoms, so that treating both the symptoms and the root causes will achieve better therapeutic effects. Of course, the purpose of treating both the symptoms and root causes can also be achieved by using internal medicine or external application alone, but it is far less effective than the simultaneous application of internal medicine and external application.

XXI. Principles and Precautions for the Treatment of Femoral Head Necrosis

A: There are twelve words for the Precautions for the Treatment of Femoral Head Necrosis, namely, no drinking, less walking, no load, and more training. At the same time, insist on medication.

XXII. Why does it take a long time to treat femoral head necrosis

A: Because femoral head necrosis is a refractory chronic disease, the course of treatment is long and the curative effect comes slowly. Therefore, don't worry about treating this disease, and don't think that it will be better to use medicine or a little medicine. There is a process of getting sick, and there is also a process of getting well. Don't rush for success. We should build up confidence and insist on treatment. Don't change places and drugs if the effect is not obvious in a short period of time. If you don't treat them systematically, you will give up all your previous efforts and start over. You have not spent less money and the disease has not been cured. Therefore, the treatment of femoral head necrosis must be systematic and persistent.

23. Can femoral head necrosis be cured?

24. What are the adverse effects of the collapse of the femoral head necrosis on the future?

The so-called collapse means that the femoral head necrosis reaches a certain level, bone cells gradually apoptosis, and the ability to withstand pressure decreases, resulting in the sum of countless small compressive fractures in the necrotic area of the femoral head. Avascular necrosis of the femoral head will not collapse in the early and middle stages, and once it collapses, it will reach the later stage. For the early and middle stage of femoral head necrosis, timely medication, timely crutches, protect the femoral head, and the head is still round after healing, so that it will be exactly the same as the healthy side in the future and the most satisfactory curative effect can be obtained. Collapse of femoral head is the inevitable result of the natural development of osteonecrosis of femoral head, and it is also the main cause of harm to human body. In other words, if osteonecrosis of femoral head does not collapse, there is no need for treatment. Collapse is irreversible, and no matter what method is used, the collapsed femoral head can not be restored to normal. The repair result of femoral head collapse is osteoarthritis, which has some sequelae. If you walk too much, the weather is cold and other reasons will bring pain, weakness and discomfort. Reducing the pressure on the femoral head is the most effective way to prevent the collapse of the femoral head. For your permanent health, don't be afraid of ugly crutches. You must follow the doctor's instructions and try to crutch as much as possible to reduce the pressure caused by the upper body weight on the femoral head and prevent collapse. Only when the femoral head is restored to the point where the dead bone is absorbed and the new bone grows, can it bear enough pressure, then it can be gradually crutched or changed.