[Preservation of necrotic bone structures: an alternative to osteonecrosis of femoral head replacement therapy].

Hip preservation treatment is the first choice for young and middle-aged patients with osteonecrosis of the femoral head (ONFH). Currently, there is considerable uncertainty in treatment outcomes, which is the dilemma faced in treating ONFH and is the main reason why young and middle-aged people undergo hip replacement. The history of hip-preserving treatment for ONFH revolves around the "substitute therapy" approach of replacing necrotic bone with various materials. As understanding of the mechanisms of bone necrosis progression deepens, the fundamental goal of hip-preserving treatment has become to protect the necrotic bone structure from destruction. In other words, the goal is to halt the progression of bone necrosis and provide sufficient time and space for creeping replacement of the necrotic bone. The core treatment method is to use minimally invasive techniques to perform bone marrow flushing on the necrotic bone. While maintaining the stability of the bone necrosis microenvironment, stem cells and organoids are used to fill the bone tissue gaps vacated by the bone marrow flushing, promoting repair of the necrotic bone and maintaining a positive balance between bone repair and bone destruction.