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. 2018 Nov 5;131(21):2589–2598. doi: 10.4103/0366-6999.244111

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Copyright: © 2018 Chinese Medical Journal

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A flow diagram for the diagnosis and treatment of ONFH based on the pericollapse theory is shown. The therapeutic regimen for ONFH should be decided by classification, stages, and risk factors rather than symptoms. For postcollapse lesions, THA is preferable. Any lesions susceptible to collapse (pericollapse stage; CJFH L1, L2, L3, and C type precollapse stage lesions) need to be managed as soon as possible to regain the internal stability of the femoral head and therefore halt the ongoing progression. The CJFH M-type precollapse stage lesions can be followed up with mere observation. ONFH: Osteonecrosis of the femoral head; THA: Total hip arthroplasty; CJFH: China-Japan Friendship Hospital.