The pathogenesis of steroid-induced osteonecrosis of the femoral head: A systematic review of the literature

Steroid (glucocorticoid)-induced osteonecrosis of the femoral head (SONFH) is a metabolic disease that occurs due to the use of glucocorticoid drugs, leading to impaired blood supply to the femoral head and death of bone cells and bone marrow composition, which in turn lead to structural change, col...

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Bibliographic Details
Published in:Gene 2018-09, Vol.671, p.103-109
Main Authors: Wang, Ao, Ren, Ming, Wang, Jincheng
Format: Article
Language:English
Subjects:
Adult
Arthroplasty - methods
Avascular necrosis
Femoral head
Femur Head Necrosis - chemically induced
Femur Head Necrosis - genetics
Femur Head Necrosis - surgery
Genetic Predisposition to Disease
Humans
Lipid Metabolism
Osteonecrosis
Pathogenesis
Precision Medicine
Quality of Life
Steroids - adverse effects
Treatment
Treatment Outcome
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Summary:Steroid (glucocorticoid)-induced osteonecrosis of the femoral head (SONFH) is a metabolic disease that occurs due to the use of glucocorticoid drugs, leading to impaired blood supply to the femoral head and death of bone cells and bone marrow composition, which in turn lead to structural change, collapse of the femoral head, and articular dysfunction. SONFH is a challenging disorder to treat in adults due to frequent collapse of the femoral head and dysfunction of the hip joint. Eventually, patients require joint arthroplasty surgery, which severely impairs the patients' quality of life. However, the exactly pathogenesis of SONFH is still not clear. Recently, as the development of precision medicine and lucubrating on stem cell and molecular biology, the exact pathogenesis of SONFH is being investigated and more new treatments are being explored. This review article discusses five major theories about the pathogenesis of SONFH. •This review article discusses five major theories about the pathogenesis of SONFH.•This review article discusses the regulating effect of non-coding RNAs in the pathogenetic process of SONFH.•The pathogenesis of SONFH is the outcome of the combined action of multiple mechanisms.
ISSN:0378-1119
1879-0038
DOI:10.1016/j.gene.2018.05.091