Abstract Injectable hydrogels are emerging as innovative therapeutic systems for osteonecrosis of the femoral head (ONFH), a condition often leading to pain, disability, and joint replacement. Since ONFH involves the progressive collapse of bone tissue due to poor vascularization, injectable hydrogels offer a minimally invasive strategy to fill necrotic regions, restore structural integrity, and deliver therapeutic agents directly to the affected site. These hydrogels transform from liquid to solid upon injection, forming scaffolds that support localized drug delivery and bone regeneration. Recent advances have introduced multifunctional hydrogels that combine therapeutic release with mechanical support, aiming to restore bone structure and delay disease progression. Although challenges remain—particularly in achieving sufficient mechanical strength and controlled release—the integration of tissue engineering and smart drug delivery highlights their strong potential as next-generation solutions for ONFH management. Lay Summary Osteonecrosis of the femoral head (ONFH) is a painful condition caused by the death of bone tissue due to reduced blood supply. It primarily affects individuals between the ages of 30 and 50 and can lead to joint collapse and the need for hip replacement. While traditional treatments, such as medications and surgeries, often fall short, recent advancements in regenerative medicine, particularly injectable hydrogels, offer a promising alternative. Injectable hydrogels are materials that can be injected into the affected area, where they solidify to support the healing process. These hydrogels can also deliver therapeutic agents like growth factors and stem cells directly to the damaged bone, promoting regeneration and improving blood flow. This treatment is minimally invasive, reducing recovery time and the need for complex surgeries. Although injectable hydrogels hold great potential, challenges remain in ensuring their mechanical strength and the controlled release of therapeutic agents. Research is focused on developing hydrogels that mimic the natural bone environment to provide both structural support and long-term benefits. The goal is to create a treatment that not only halts disease progression but also helps restore bone function and integrity. In summary, injectable hydrogels represent an exciting development in the treatment of ONFH, offering a less invasive and more effective alternative to current treatments. However, ongoing research is critical to overcoming challenges related to their strength and the precise delivery of therapeutic agents. Graphical Abstract

Injectable Hydrogels for Treating Osteonecrosis of the Femoral Head

期刊论文
发表日期：

2025年9月30日

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Masoumeh Askari,
Ali Rajabi,
Hengameh Dortaj

摘要

Abstract

Injectable hydrogels are emerging as innovative therapeutic systems for osteonecrosis of the femoral head (ONFH), a condition often leading to pain, disability, and joint replacement. Since ONFH involves the progressive collapse of bone tissue due to poor vascularization, injectable hydrogels offer a minimally invasive strategy to fill necrotic regions, restore structural integrity, and deliver therapeutic agents directly to the affected site. These hydrogels transform from liquid to solid upon injection, forming scaffolds that support localized drug delivery and bone regeneration. Recent advances have introduced multifunctional hydrogels that combine therapeutic release with mechanical support, aiming to restore bone structure and delay disease progression. Although challenges remain—particularly in achieving sufficient mechanical strength and controlled release—the integration of tissue engineering and smart drug delivery highlights their strong potential as next-generation solutions for ONFH management.

Lay Summary

Osteonecrosis of the femoral head (ONFH) is a painful condition caused by the death of bone tissue due to reduced blood supply. It primarily affects individuals between the ages of 30 and 50 and can lead to joint collapse and the need for hip replacement. While traditional treatments, such as medications and surgeries, often fall short, recent advancements in regenerative medicine, particularly injectable hydrogels, offer a promising alternative. Injectable hydrogels are materials that can be injected into the affected area, where they solidify to support the healing process. These hydrogels can also deliver therapeutic agents like growth factors and stem cells directly to the damaged bone, promoting regeneration and improving blood flow. This treatment is minimally invasive, reducing recovery time and the need for complex surgeries. Although injectable hydrogels hold great potential, challenges remain in ensuring their mechanical strength and the controlled release of therapeutic agents. Research is focused on developing hydrogels that mimic the natural bone environment to provide both structural support and long-term benefits. The goal is to create a treatment that not only halts disease progression but also helps restore bone function and integrity. In summary, injectable hydrogels represent an exciting development in the treatment of ONFH, offering a less invasive and more effective alternative to current treatments. However, ongoing research is critical to overcoming challenges related to their strength and the precise delivery of therapeutic agents.

Graphical Abstract