Potential implications of cytokines and growth factors in the treatment ofosteonecrosis

Osteonecrosis of the femoral head remains a devastating disease for young p atients. As the normal process of bone formation, bone destruction, and fra cture healing becomes more clearly understood, molecular agents including c ytokines, bone morphogenetic proteins, and angiogenic factors - will be ide ntified as potential therapeutic agents for the treatment of osteonecrosis. As the pathology of osteonecrosis and repair of osteonecrotic lesions beco mes clear, the potential combination of these molecular factors to influenc e the outcome of the disease in its repair process should become evident. W ith the myriad of agents and combinations of agents which may be beneficial in the treatment of osteonecrosis, a reproducible animal model is urgently needed to determine which of these combinations is most effective. Despite the lack of an animal model, progress in the use of cytokines for osteonec rosis treatment in conjunction with traditional treatment methods is possib le in human subjects. This is due to the extremely low incidence of adverse reactions when these cytokines are used locally in nanogram to microgram q uantities.