Epidemiology of osteonecrosis of the femoral head in South Korea

Osteonecrosis of the femoral head (ONFH) is known to be related to decreased blood supply [1–3]. This may be primary, or idiopathic, in which no clear etiological factor can be established or secondary to several known causative factors [4, 5]. Underlying causes of ONFH can include alcohol abuse, systemic steroid use, Caisson disease, Gaucher’s disease, and sickle cell anemia [4, 5]. Regardless of etiology, the histological picture includes death of osteocytes and structural changes in the femoral head, leading to osteoarthritis of the hip [6]. However, apart from these few facts, we still do not understand the exact epidemiology, patho-mechanism, or natural history of the disease.