ARCO Consensus on the Pathogenesis of Non-traumatic Osteonecrosis of the Femoral Head

Abstract

Osteonecrosis of the femoral head (ONFH) is a devastating disease frequently leading to femoral head collapse and hip arthritis. Specifically, non-traumatic ONFH primarily affects young and middle-aged adults. Although compromised local circulation of the femoral head seems to be pathognomonic for the disease, the pathogenesis is perplexing and continues to be an area of scrutiny and research. Comprehension of the pathogenesis is of crucial importance for developing and guiding treatments for the disease. Therefore, we provide an up-to-date consensus on the pathogenesis of non-traumatic ONFH.

Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment

“…In 2019, ARCO task force developed a plausible model to explain the pathogenetic of non-traumatic ONFH. 52 …”

Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

“…It can be considered that FV Leiden and resistance to activated protein C represent the same type of thrombophilia, as they are the consequences of different mutations of the FV gene. While FV Leiden is commonly associated with the pathogenesis of ONFH, there is no data showing a link between acquired activated protein C resistance and the risk of ONFH-although it has been described as a risk factor for thrombosis [60,[68][69][70].…”

Polymer Scaffolds-Enhanced Bone Regeneration in Osteonecrosis Therapy

“…Osteonecrosis is a disease caused by the destruction of blood supply and decreased skeletal cell activity (Guo et al, 2014;Cui et al, 2021;Hines et al, 2021). The reconstruction of bone and blood supply in the necrotic area is the top priority in treating osteonecrosis (Zhu et al, 2020).…”

“…Osteonecrosis is a disease caused by a temporary or permanent loss of blood supply to the bone. The causes of osteonecrosis are extensive, and the pathogenesis is still unclear (Guo et al, 2014;Cui et al, 2021;Hines et al, 2021). The potential pathogenic factors that have been explored include trauma (Pascarella et al, 2019), long-term history of heavy drinking (Chen et al, 2017), hyperlipidemia (Mogensen et al, 2017), history of hormone medication (Li et al, 2018b), decompression sickness (Jones et al, 1993), and blood system diseases such as Gaucher disease (Reed et al, 2018) and sickle cell anemia (Severyns and Gayet, 2021) among others.…”

“…Ineffective repairs such as fibrous tissue repair cannot replace the original bone tissue in terms of structure and support performance. Therefore, osteonecrosis involving joints often leads to the gradual collapse of the articular surface, which in turn causes arthritis (Calder et al, 2001;Hernigou et al, 2020;Cui et al, 2021).…”