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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2024 | Glucocorticoid | Review

Research progress in the pathogenesis of hormone-induced femoral head necrosis based on microvessels: a systematic review

Authors: Tiancheng Ma, Yan Wang, Jianxiong Ma, Hongwei Cui, Xiaotian Feng, Xinlong Ma

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Hormonal necrosis of the femoral head is caused by long-term use of glucocorticoids and other causes of abnormal bone metabolism, lipid metabolism imbalance and blood microcirculation disorders in the femoral head, resulting in bone trabecular fracture, bone tissue necrosis collapse, and hip dysfunction. It is the most common type of non-traumatic necrosis of the femoral head, and its pathogenesis is complex, while impaired blood circulation is considered to be the key to its occurrence. There are a large number of microvessels in the femoral head, among which H-type vessels play a decisive role in the “angiogenesis and osteogenesis coupling”, and thus have an important impact on the occurrence and development of femoral head necrosis. Glucocorticoids can cause blood flow injury of the femoral head mainly through coagulation dysfunction, endothelial dysfunction and impaired angiogenesis. Glucocorticoids may inhibit the formation of H-type vessels by reducing the expression of HIF-1α, PDGF-BB, VGEF and other factors, thus causing damage to the “angiogenesis-osteogenesis coupling” and reducing the ability of necrosis reconstruction and repair of the femoral head. Leads to the occurrence of hormonal femoral head necrosis. Therefore, this paper reviewed the progress in the study of the mechanism of hormone-induced femoral head necrosis based on microvascular blood flow at home and abroad, hoping to provide new ideas for the study of the mechanism of femoral head necrosis and provide references for clinical treatment of femoral head necrosis.

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Title: Research progress in the pathogenesis of hormone-induced femoral head necrosis based on microvessels: a systematic review
Authors: Tiancheng Ma
Yan Wang
Jianxiong Ma
Hongwei Cui
Xiaotian Feng
Xinlong Ma
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Glucocorticoid
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-024-04748-2

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Research progress in the pathogenesis of hormone-induced femoral head necrosis based on microvessels: a systematic review

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