Ways to Improve Preventive Measures in Aseptic Necrosis of the Femoral Head (literature review)

Aseptic necrosis of the femoral head is a severe disease leading to disability of patients of working age. The article presents a comprehensive analysis of modern approaches to the prevention, early diagnosis and treatment of ANFH, based on the systematization of international research data. The aim of the study is to implement a comprehensive approach to prevention, early diagnosis, personalized treatment, preservation of joint function and the development of scientific and organizational measures to reduce morbidity, disability and improve the quality of life of patients with aseptic necrosis of the femoral head. The main attention is paid to early screening using MRI, which detects preclinical stages in 85% of patients from risk groups (taking corticosteroids, injuries, alcohol dependence). The role of lifestyle modification, including quitting alcohol and smoking, normalizing BMI, and using calcium, vitamin D and bisphosphonates to strengthen bone tissue is emphasized. Strategies for optimizing therapy for systemic diseases are considered: replacing corticosteroids with biological agents, controlling hyperlipidemia, diabetes and hypercoagulability. Particular importance is attached to interdisciplinary protocols, such as the Japanese screening program, which reduced the incidence of late diagnosis by 40%, and personalized approaches, including genetic testing. The author emphasizes the need to implement educational programs for doctors and patients, as well as the integration of technologies (telemedicine) to improve the effectiveness of prevention. The research results confirm that complex measures reduce the risk of necrosis progression by 40–60%, reducing the need for endoprosthetics. The article serves as a basis for the development of clinical guidelines and government programs aimed at reducing the incidence of ANFH.