Xu Jianzhong, Gong Hanpu, Lu Shitao, Deasey Matthey J, Cui Quanjun
Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, People's Republic of China.
Department of Orthopaedic Surgery, University of Virginia School of Medicine, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA 22903, USA.
Int Orthop. 2018 Jul;42(7):1729-1737. doi: 10.1007/s00264-018-3956-1. Epub 2018 Apr 28.
Osteonecrosis of the femoral head (ONFH) is a significant cause of both pain and disability that often affects young adults during what ought to be their most productive age. Two broad categories of ONFH exist: traumatic and non-traumatic. Traumatic ONFH results from acute mechanical disruption of the femoral head's blood supply. Many factors that increase the risk of non-traumatic osteonecrosis have been identified. Steroid-induced osteonecrosis of the femoral head (SONFH) is the most common form of non-traumatic ONFH. Many hypotheses as to the pathogenesis of SONFH have been proposed, including intravascular thrombosis, abnormal fat metabolism, intramedullary adipocyte hypertrophy, and osteoporosis; however, the exact mechanism of SONFH is still not clearly understood. Animal models using rats, mice, rabbits, chickens, pigs, and emus have been used to study SONFH. Unfortunately, these models each have limitations. Therefore, it is necessary to establish a reproducible model that better simulates human disease. The present review is intended to summarize the currently available models, evaluative indicators, and application of current understanding to both the prevention and treatment of SONFH.
股骨头坏死(ONFH)是导致疼痛和残疾的一个重要原因,常影响处于本应是其最具生产力年龄段的年轻人。股骨头坏死存在两大类:创伤性和非创伤性。创伤性股骨头坏死是由股骨头血供的急性机械性破坏所致。已确定许多增加非创伤性骨坏死风险的因素。类固醇诱导的股骨头坏死(SONFH)是最常见的非创伤性股骨头坏死形式。关于类固醇诱导的股骨头坏死的发病机制已提出许多假说,包括血管内血栓形成、脂肪代谢异常、骨髓内脂肪细胞肥大和骨质疏松;然而,类固醇诱导的股骨头坏死的确切机制仍未完全清楚。已使用大鼠、小鼠、兔子、鸡、猪和鸸鹋等动物模型来研究类固醇诱导的股骨头坏死。不幸的是,这些模型各有局限性。因此,有必要建立一个能更好模拟人类疾病的可重复性模型。本综述旨在总结目前可用的模型、评估指标以及当前认识在类固醇诱导的股骨头坏死预防和治疗中的应用。