Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview)

Xie, Xin-Hui; Wang, Xin-Luan; Yang, Hui-Lin; Zhao, De-Wei; Qin, Ling

Decreased bone formation in SAON was regarded as the common cause of osteoporosis. Weinstein administered prednisolone to mice and observed a decrease in bone density, serum osteocalcin, and cancellous bone area along with trabecular narrowing, accompanied by diminished bone formation and turnover. Takano-Murakami et al [18] also recently found that methylprednisolone (MPSL) sodium succinate inhibited bone formation by suppressing osteoblasts proliferation and bone resorption by suppressing the recruitment of osteoclasts precursors [19] . Thus, the decreased function of osteoblasts and osteoclasts or impaired balance between the two cell types by corticosteroids would result in bone matrix degeneration, which explained the delayed bone fracture healing in animals or patients under steroid administration [12] .