Bisphosphonates in the Prevention of Collapse of the Femoral Head in Nontraumatic Osteonecrosis

Nontraumatic osteonecrosis (ON) is one of the most debilitating skeletal complications, yet the cause of the disease remains controversial. Each year, 10,000–20,000 new cases are diagnosed in the United States alone [1, 2] and about half of the total hip replacement cases in Taiwan were the result of debilitating osteoarthritis from ON [3]. Moreover, with the majority of the disease population comprising younger patients with late diagnosis, this leads to severe socioeconomic burdens and increased suffering on the part of the patient, beyond the problems of early loosening and multiple procedures [1].