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

Of all the nontraumatic factors, corticosteroid usage is the major associated one [5] . ON development was associated with dose and duration of administrating corticosteroids [6] . Usually, the chronic administration of high-dose steroids will result in ON, but it is very difficult to predict which patient under steroid administration will finally develop ON. Dynamic magnetic resonance imaging (MRI) was a promising method for potentially better prediction in an SAON rabbit model [7] and human trials shall be conducted to confirm the value of SAON development already in Phase 0. A retrospective study showed that the interval between steroid administration and the ON onset was from 6 months to > 3 years. The prospective study using MRI to detect early ON of the femoral head showed that the initial changes of necrosis were found at about 3 months after administration of steroids.