Decrease in the mesenchymal stem-cell pool in the proximal femur in corticosteroid-induced osteonecrosis.

We have evaluated bone-marrow activity in the proximal femur of patients with corticosteroid-induced osteonecrosis and compared it with that of patients with osteonecrosis related to sickle-cell disease and with a control group without osteonecrosis. Bone marrow was obtained by puncture of the femoral head outside the area of necrosis and in the intertrochanteric region. The activity of stromal cells was assessed by culturing fibroblast colony-forming units (FCFUs). We found a decrease in the number of FCFUs outside the area of osteonecrosis in the upper end of the femur of patients with corticosteroid-induced osteonecrosis compared with the other groups. We suggest that glucocorticosteroids may also have an adverse effect on bone by decreasing the number of progenitors. The possible relevance of this finding to osteonecrosis is discussed.

[1]  P. Hernigou.  Autologous bone marrow grafting of avascular osteonecrosis before collapse , 2001, Arthritis Research.

[2]  Gwo‐Jaw Wang,et al.  Lovastatin Prevents Steroid Induced Adipogenesis and Osteonecrosis , 1997 .

[3]  P. Hernigou,et al.  Abnormalities in the Bone Marrow of the Iliac Crest in Patients Who Have Osteonecrosis Secondary to Corticosteroid Therapy or Alcohol Abuse* , 1997, The Journal of bone and joint surgery. American volume.

[4]  Gwo‐Jaw Wang,et al.  Steroid-Induced Adipogenesis in a Pluripotential Cell Line from Bone Marrow* , 1997, The Journal of bone and joint surgery. American volume.

[5]  M. Adkins.  Diagnosis of Bone and Joint Disorders , 1997 .

[6]  J. Triffitt,et al.  In vitro effects of growth factors and dexamethasone on rat marrow stromal cells. , 1995, Clinical orthopaedics and related research.

[7]  W. Doherty,et al.  The effect of glucocorticoids on osteoblast function. The effect of corticosterone on osteoblast expression of beta 1 integrins. , 1995, The Journal of bone and joint surgery. American volume.

[8]  L. Solomon,et al.  Early detection of avascular necrosis of the femoral head by MRI. , 1993, The Journal of bone and joint surgery. British volume.

[9]  H. Plenk,et al.  Bone-marrow oedema syndrome and transient osteoporosis of the hip. An MRI-controlled study of treatment by core decompression. , 1993, The Journal of bone and joint surgery. British volume.

[10]  L W Hedlund,et al.  Detection of acute avascular necrosis of the femoral head in dogs: dynamic contrast-enhanced MR imaging vs spin-echo and STIR sequences. , 1992, AJR. American journal of roentgenology.

[11]  C. Devlin,et al.  Evidence for an inverse relationship between the differentiation of adipocytic and osteogenic cells in rat marrow stromal cell cultures. , 1992, Journal of cell science.

[12]  K. Brandt,et al.  Apparent avascular necrosis of the hip: appearance and spontaneous resolution of MR findings in renal allograft recipients. , 1991, Radiology.

[13]  H Y Kressel,et al.  Magnetic resonance imaging of the ischemic hip. Alterations within the osteonecrotic, viable, and reactive zones. , 1989, Clinical orthopaedics and related research.

[14]  J N Beresford,et al.  Osteogenic stem cells and the stromal system of bone and marrow. , 1989, Clinical orthopaedics and related research.

[15]  C. Joyner,et al.  Clonal analysis in vitro of osteogenic differentiation of marrow CFU-F. , 1987, Journal of cell science.

[16]  A. Friedenstein,et al.  Bone marrow osteogenic stem cells: in vitro cultivation and transplantation in diffusion chambers , 1987, Cell and tissue kinetics.

[17]  K. Ono,et al.  Intramedullary haemorrhage as a possible cause of avascular necrosis of the femoral head. The histology of 16 femoral heads at the silent stage. , 1987, The Journal of bone and joint surgery. British volume.

[18]  D. Mitchell,et al.  Hematopoietic and fatty bone marrow distribution in the normal and ischemic hip: new observations with 1.5-T MR imaging. , 1986, Radiology.

[19]  G. Ringold,et al.  Glucocorticoid regulation of adipocyte differentiation: hormonal triggering of the developmental program and induction of a differentiation-dependent gene , 1985, The Journal of cell biology.

[20]  Gwo‐Jaw Wang,et al.  Steroid-induced femoral head pressure changes and their response to lipid-clearing agents. , 1983, Clinical orthopaedics and related research.

[21]  H. Broxmeyer,et al.  Characterization of human bone marrow fibroblast colony-forming cells (CFU-F) and their progeny. , 1980, Blood.

[22]  Gj Wang,et al.  Fat-cell changes as a mechanism of avascular necrosis of the femoral head in cortisone-treated rabbits. , 1977, The Journal of bone and joint surgery. American volume.

[23]  R Storb,et al.  Technique for human marrow grafting. , 1970, Blood.

[24]  D. Dyke.  Similarity in Distribution of Skeletal Blood Flow and Erythropoietic Marrow , 1967 .

[25]  E. Rutishauser,et al.  [Articular ischemia in human and experimental pathology. The concept of vascular pannus]. , 1966, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur.

[26]  J. Emery,et al.  Regression of Bone‐Marrow Haemopoiesis from the Terminal Digits in the Foetus and Infant , 1964, British journal of haematology.

[27]  M. Hashimoto.  Pathology of bone marrow. , 1962, Acta haematologica.

[28]  M. Hashimoto.  The distribution of active marrow in the bones of normal adult. , 1960 .

[29]  K. Tomita,et al.  Histopathologic study of veins in steroid treated rabbits. , 1997, Clinical orthopaedics and related research.

[30]  C. Glueck,et al.  Thrombophilia and hypofibrinolysis: pathophysiologies of osteonecrosis. , 1997, Clinical orthopaedics and related research.

[31]  B. Ashton,et al.  Human bone-cell proliferation in vitro decreases with human donor age. , 1995, The Journal of bone and joint surgery. British volume.

[32]  菅野 伸彦,et al.  Prognostication of nontraumatic avascular necrosis of the femoral head : significance of location and size of the necrotic lesion , 1994 .

[33]  D. Bachir,et al.  Deformities of the hip in adults who have sickle-cell disease and had avascular necrosis in childhood. A natural history of fifty-two patients. , 1991, The Journal of bone and joint surgery. American volume.

[34]  F. V. Van Ginkel,et al.  Bone marrow and bone remodeling. , 1985, Bone.

[35]  Ficat Rp.  Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. , 1985 .

[36]  E. Rutishauser,et al.  [Experimental studies on the effect of ischemia on the bone and marrow]. , 1960, Virchows Archiv fur pathologische Anatomie und Physiologie und fur klinische Medizin.