The latest research on the pathogenesis of osteonecrosis of the femoral head / 中国组织工程研究

ABSTRACT

BACKGROUND: Theories concerning the pathogenesis of osteonecrosis of the femoral head (ONFH) are various, such as blood supply dysfunction, lipid metabolism disorder, increased intraosseous pressure, osteocyte apoptosis, gene polymorphism and immunity, but the underlying mechanisms remain unclear.OBJECTIVE: To review the pathogenesis of ONFH, thus providing clues for the study on ONFH.METHODS: Search strategy femoral head necrosis OR osteonecrosis of femoral head AND pathogenesis OR mechanism was used to search articles published between 1985 to 2017 in PubMed, Embase, and Medline databases.Meanwhile, CNKI, WanFang and VIP databases were searched with Chinese keywords of femoral head necrosis,pathogenesis from 1985 to 2017. Finally, 39 articles were included for retrospective analysis.RESULTS AND CONCLUSION: ONFH is a complex disease caused by a variety of factors, among which, biomechanics plays an important role in its occurrence and development. The internal mechanic strength of the femoral head is reduced or the imbalance between external stress and inner structures of femoral head caused by various risk factors leads to micro-fractures of the trabeculae, stress concentration and repeated destruction and repair. When the destruction rate exceeds the repair speed, the femoral heads eventually collapse. Most of ONFH cases are sporadic, but its familial aggregation has been reported; therefore, it may be related with genetic factor.