Basic Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2018; 9(9): 120-129
Published online Sep 18, 2018. doi: 10.5312/wjo.v9.i9.120
Vascular endothelial growth factor for the treatment of femoral head osteonecrosis: An experimental study in canines
Zoe H Dailiana, Nikolaos Stefanou, Lubna Khaldi, Georgios Dimakopoulos, James R Bowers, Cristian Fink, James R Urbaniak
Zoe H Dailiana, Nikolaos Stefanou, Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, Larissa 41500, Greece
Zoe H Dailiana, James R Bowers, Cristian Fink, James R Urbaniak, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, United States
Lubna Khaldi, Department of Pathology, “Saint Savvas” Anti-Cancer Hospital, Athens 11522, Greece
Georgios Dimakopoulos, Medical Statistics, Epirus Science and Technology Park Campus of the University of Ioannina, Ioannina 45500, Greece
James R Bowers, Emerge Ortho, Independence Park, Durham, NC 27704, United States
Cristian Fink, Gelenkpunkt, Sports and Joint Surgery, Innsbruck 6020, Austria
Cristian Fink, Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Tirol 6060, Austria
Author contributions: Dailiana ZH participated in the inception and design of the study, the acquisition and the interpretation of the data, and wrote the manuscript; Stefanou N critically reviewed the findings and wrote the manuscript; Khaldi L performed the qualitative histological estimation, quantitative bone histomorphometry and the photography of sections, wrote the histological/histomorphometrical materials and methods and the histological figure legends; Dimakopoulos G performed the statistical analysis; Bowers JR and Fink C participated in the acquisition and interpretation of the data and helped draft the manuscript; Urbaniak JR participated in the inception and design of the study, critically reviewed the findings, and revised the manuscript.
Supported by Piedmont Orthopaedic Foundation, United States.
Institutional review board statement: The experimental study was approved from the Institutional Animal Care and Use Committee of Duke University.
Conflict-of-interest statement: We have no financial relationships to disclose.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Zoe H Dailiana, MD, PhD, Professor, Surgeon, Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou St., Larissa 41500, Greece.
Telephone: +30-24-13502722 Fax: +30-24-13501011
Received: March 29, 2018
Peer-review started: March 29, 2018
First decision: April 29, 2018
Revised: June 20, 2018
Accepted: June 26, 2018
Article in press: June 27, 2018
Published online: September 18, 2018
Core Tip

Core tip: Osteonecrosis of the femoral head (ONFH) is a painful disorder which usually results in hip joint destruction. Although the pathogenic process is poorly understood, ON is the final condition that completes an already precarious microcirculation of the FH by traumatic and non-traumatic causes. Since vascular endothelial growth factor (VEGF) regulates numerous cellular events associated with angiogenesis and osteogenesis, we evaluated, in an experimental model of ONFH in canines if the local treatment with VEGF leads to bone tissue remodeling and new bone formation at the necrotic site, and subsequently to reversal of ON.