Table 1: New developments on pathogenesis of nontraumatic osteonecrosis and its clinical significance.

New findingsClinical significance

Steroids enhance adipogenesis and inhibit osteogenesis and angiogenesis by marrow stem cells [53, 54, 56] Therapeutic modulating marrow stem cell
Statins have shown therapeutic effects [54, 56, 74]
 Alcohol stimulate adipogenesis and inhibit osteogenesis by marrow stem cells [40, 65]Therapeutic modulating marrow stem cell
Heritable hypofibrinolysis and thrombophilia [32, 34, 40, 50, 72]Anticoagulation therapy is effective [75]
Genetic associations
 Mutations in the COL2A1 gene [30]Familial high risk group
 Polymorphisms in alcohol metabolizing enzyme gene [29]High risk subgroup
 Polymorphisms in the multidrug resistance gene 1 [73]Screening high risk patients [73]