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Published on: September 27, 2024
685
Osteonecrosis: A More Appropriate Term than Avascular Necrosis-Pathophysiologic Rationale.
Edward Y Cheng1, Alireza Mirzaei1, Nobuhiko Sugano2
1Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota.
The Journal of Arthroplasty
|May 28, 2025
Summary
Nontraumatic osteonecrosis results from disrupted bone homeostasis, not solely vascular issues. Using "osteonecrosis" promotes understanding and better treatment strategies for this bone death condition.
Area of Science:
- Orthopedics
- Pathophysiology
- Medical Terminology
Background:
- Nontraumatic osteonecrosis is often attributed to vascular insufficiency, causing bone death.
- Current terminology like "avascular necrosis" may overemphasize vascular causes, limiting treatment options.
- Inconsistent terminology fails to capture the complex pathogenesis of the condition.
Purpose of the Study:
- To review the evolution of terminology for nontraumatic osteonecrosis.
- To evaluate the diverse pathophysiologic mechanisms involved.
- To assess the clinical and conceptual impact of common terms.
Main Methods:
- Comprehensive literature review.
- Analysis of pathophysiologic mechanisms.
- Evaluation of clinical and conceptual implications of terminology.
Main Results:
- Disrupted bone homeostasis is the common pathway in nontraumatic osteonecrosis.
- Pathogenesis can involve vascular or vascular-independent mechanisms.
- Over-reliance on vascular terms may lead to biased clinical management.
Conclusions:
- "Osteonecrosis" is a more accurate term reflecting multifactorial causes.
- Wider adoption of "osteonecrosis" can improve understanding of disease mechanisms.
- This shift may encourage innovative, multimodal treatment strategies.
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