Why the stage changes the whole conversation
Hip avascular necrosis is not one condition with one operation. It is a process in which the blood supply to part of the femoral head is interrupted, and the amount of bone already affected is what separates a joint-preserving procedure from a replacement. A report that says only 'avascular necrosis of the right hip' does not tell a surgeon whether the femoral head has collapsed, whether the cartilage surface is still intact, or whether the lesion is small and peripheral or large and central.
That distinction matters because the two families of treatment answer different questions. Joint-preserving options aim to keep your own femoral head; replacement removes the damaged ball-and-socket surfaces and substitutes artificial components. The source material for total hip replacement describes exactly that: replacing damaged surfaces with artificial components, with suitability assessed individually. It does not say replacement is the right answer for every stage, and it does not say preservation always works. Both are decisions a treating surgeon makes after seeing your images and examining you.
So the practical question is not 'which operation is better'. It is 'what does my imaging actually show, and has anyone formally staged it?' If you cannot answer that, a China enquiry will produce vague replies, because the surgeon is being asked to choose a procedure without the one piece of information that drives the choice.
What a usable staging record contains
Staging systems for avascular necrosis combine findings from imaging with the clinical picture. Different systems are in use, and a surgeon may refer to a stage number, a descriptive category, or both. What you need is not a particular classification name but enough detail for an independent reader to reach the same conclusion.
A usable record normally includes the imaging modality and the date, which hip is affected, whether the changes are on one side or both, the size and location of the affected area within the femoral head, and whether there is any evidence of subchondral collapse or joint-surface change. It should also state whether the findings are stable compared with any earlier study. If your report contains a stage, note which system it uses; if it does not, that is a question for the reviewing clinician rather than something to guess.
Bilateral assessment deserves specific attention. Avascular necrosis can affect both hips, sometimes with symptoms on one side only, and a plan built on one hip may need revisiting if the other side is also involved. Ask whether both hips have been imaged and reported, and bring both sets of images if they exist.
Finally, keep the report and the images together. A report is a radiologist's interpretation; the images are the primary data. A surgeon reviewing your case will want to look at the actual sequences, not only the summary, because staging decisions often turn on details the report compresses into a sentence.
Getting the original imaging files, not screenshots
A remote review can stall when the patient sends photographs of a screen, a printed report, or a compressed image exported from a phone. Those are useful for orientation and useless for staging. What a reviewing surgeon needs is the original cross-sectional study in a format that can be opened and scrolled through.
In practice this means requesting the DICOM files for your MRI, and for any CT you have had, from the imaging centre that performed the study. Many centres can provide these on a disc or via a secure download link. Ask specifically for the complete series, not a selection, and ask whether the files include the localiser and all sequences. If you have had more than one MRI, request each study separately with its date, so a reviewer can compare them.
It also helps to know what you have already tried and what has been recommended. A short typed summary of your symptoms, when they started, what makes them worse, what medication or physiotherapy you have used, and what your local clinician has proposed gives the reviewer context that images alone cannot. Keep it factual and brief; the images carry the diagnostic weight.
One administrative point worth confirming early: ask the receiving hospital or coordination team what file format and transfer method they accept, and whether they need the radiology report translated. Do not assume a particular portal or format will work. This is a question to put in writing before you spend time exporting files.
Previous hip procedures and the surgical history
If you have already had surgery on the affected hip, that history is part of the staging picture, not background noise. Previous procedures change the anatomy, may affect blood supply, and influence what a surgeon considers technically feasible. A reviewer who does not know about them may reach a conclusion that does not apply to your hip.
Gather the operation notes, not just the discharge summary. Operation notes describe what was actually done, what was found, and what implants, if any, were used. If you have had a previous joint-preserving procedure, a fixation, or any surgery near the hip, include the date, the hospital, the procedure name, and the implant details if available. If you have had a previous hip replacement on the other side, that is relevant too, because it informs the discussion about the second hip.
It is also worth listing any other conditions and current medications, particularly anything that affects bone health, clotting, or infection risk. You are not being asked to interpret these; you are making sure the reviewer has them. If a record is missing and cannot be obtained, say so explicitly rather than leaving a gap that a reviewer might fill with an assumption.
For patients who have had no previous hip surgery, this section is short: state clearly that there is no surgical history on that hip, and note any injections, aspirations, or procedures that were done. Clarity here prevents the reviewer from asking a question you could have answered in advance.
Joint preservation versus replacement: what to ask, not what to assume
The choice between preserving the joint and replacing it is a clinical judgement that depends on stage, the extent and location of the lesion, the condition of the joint surface, your age and activity, your symptoms, and your own priorities. It is not a decision that can be made from a report alone, and it is not a decision this article can make for you.
What you can do is prepare the questions that make the consultation productive. Ask whether your imaging shows collapse of the femoral head, because that finding often separates the two pathways. Ask what joint-preserving options exist for your specific pattern of disease, and what the evidence says about how long they tend to last. Ask what happens if preservation fails or is not suitable, and what a replacement would involve in your case. Ask about the risks of each route, including the risk of further surgery.
You should also ask about the limits of a records-based opinion. A surgeon reviewing your files without examining you can discuss staging, options, and general risks, but cannot confirm final suitability or guarantee an outcome. That confirmation comes from an in-person assessment. If a service presents a remote review as a final decision, treat that as a reason to ask more questions, not fewer.
Finally, ask about alternatives you may not have considered, including non-surgical management and the option of watchful waiting where appropriate. A good consultation will explain why a particular route is being recommended and what would change the recommendation. If you do not understand the reasoning, say so; the decision is yours to make with the clinician, and understanding it is part of the process.
Sending records to China and what happens next
Once your imaging and history are assembled, the practical step is to send a short summary first. An initial enquiry does not require a complete medical archive, and it does not require buying a proxy consultation. A brief description of the diagnosis, the stage if known, the imaging you hold, and your main question is enough for the team to identify what is missing and suggest a relevant next step.
From there, the route depends on your situation. Some patients want a records-based opinion before deciding whether to travel; others want an appointment with a specialist. These are different services with different scopes, and neither guarantees hospital acceptance or a particular outcome. If you are considering a review, ask what the reviewing clinician will receive, what they will and will not be able to conclude, and how the opinion will be communicated to you.
Do not delay necessary local care while an overseas enquiry is in progress. If your symptoms are worsening, or if you develop new problems, seek assessment where you are. An overseas review is a planning step, not an emergency service.
A reasonable next step is to gather your original imaging files and a one-page history, then send a brief summary through the enquiry form, email, or WhatsApp. The team can then tell you what else is needed and which route fits your question. Keep the process focused on the decision you actually need to make: whether your stage and imaging support a joint-preserving approach, a replacement, or further assessment.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.