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Open Access Research article

The effect of core decompression on local expression of BMP-2, PPAR-γ and bone regeneration in the steroid-induced femoral head osteonecrosis

Wei Wang1, Liying Liu2, Xiaoqian Dang1, Shuqiang Ma3, Mingyu Zhang4 and Kunzheng Wang1*

Author affiliations

1 Department of Orthopaedics, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, Shaanxi, 710004, People's Republic of China

2 Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061, P.R. China

3 Futian District Hospital, Shenzhen, Guangdong, 518000, People's Republic of China

4 Xi’an Red Cross Hospital, Xi’an, Shaanxi, 710054, People's Republic of China

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Citation and License

BMC Musculoskeletal Disorders 2012, 13:142  doi:10.1186/1471-2474-13-142

Published: 9 August 2012

Abstract

Background

To investigate the efficacy of the sole core decompression surgery for the treatment of steroid-induced femoral head osteonecrosis.

Methods

The model was established by administration of steroids in combination with horse serum. The rabbits with bilateral femoral head osteonecrosis were randomly selected to do the one side of core decompression. The other side was used as the sham. Quantitative RT-PCR and western blot techniques were used to measure the local expression of BMP-2 and PPAR-γ. Bone tissues from control and operation groups were histologically analyzed by H&E staining. The comparisons of the local expression of BMP-2 and PPAR-γ and the bone regeneration were further analyzed between different groups at each time point.

Results

The expression of BMP-2 in the osteonecrosis femoral head with or without decompression was significantly lower than that in normal animals. BMP-2 expression both showed the decreasing trend with the increased post-operation time. No significant difference of BMP-2 expression occurred between femoral head osteonecrosis with and without decompression. The PPAR-γ expression in the femoral head osteonecrosis with and without core decompression both was significantly higher than that in control. Its expression pattern showed a significantly increased trend with increased the post-operation time. However, there was no significant difference of PPAR-γ expression between the femoral head osteonecrosis with and without decompression at each time point. Histopathological analysis revealed that new trabecular bone and a large number of osteoblasts were observed in the steroid-induced femoral head osteonecrosis with lateral decompression at 8 weeks after surgery, but there still existed trabecular bone fractures and bone necrosis.

Conclusions

Although decompression takes partial effect in promoting bone regeneration in the early treatment of femoral head osteonecrosis, such an effect does not significantly improve or reverse the pathological changes of femoral head necrosis. Thus, the long-term effect of core decompression in the treatment of steroid-induced femoral head osteonecrosis is not satisfactory.

Keywords:
Steroid-induced osteonecrosis; Core decompression; BMP-2; PPAR-γ