Table 1.
Etiology/risk factors | Current treatments | Role of vasculature | |
---|---|---|---|
Osteoporosis, loss of bone density | Altered balance of bone remodeling: greater bone removal by osteoclasts and then production by osteoblasts [18] | Administration of bisphosphonates, which shorten osteoclast life span and inhibit bone resorption [19] | Possible link between decreased production of vasodilator molecules by endothelial cells and increased bone loss [20] |
Osteoarthritis, progressive degeneration of cartilage and bone | Traumatic, congenital, postoperative, metabolic, endocrine; age, joint overuse, obesity are common risk factors [274] | Symptomatic treatments through physiotherapy, orthopedic aids and orthoses, pharmacotherapy, total joint replacement [275] | Increased vascularization and neoangiogenesis in the joint; increase in VEGF level in osteoarthritic chondrocytes [43] |
Osteomyelitis, infection within bone | Infection by Staphylococcus aureus, but also by other Gram-negative cocci and Gram-positive bacilli [45] | Parenteral course of broad-spectrum antibiotics and surgical debridement[46] | Poor vascularity can cause both development of the infection and resistance to antibiotics [46] |
Osteonecrosis, death of bone cells, arthritis, and destruction of bone | Inadequate vascular supply to the bone; long-term steroid treatment, alcohol abuse, joint injury, arthritis, cancer are common risk factors [52] | Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation; bone surgery, grafting, and joint replacement [276] | Compromised subchondral microcirculation, vascular interruption, intravascular occlusion, and extravascular compression [277] |
Fractures, loss of bone contiguity | Mainly trauma; osteoporosis, low mineral density, age, tumors are common risk factors [278–280] | Fracture reduction and immobilization; bone autograft, allograft, or synthetic materials [59] | Vascular supply is critical for fracture healing; VEGF treatment can enhance fracture repair [57] |
Osteosarcoma, bone malignancy | Occurring mostly in the medullary cavity of long bones: environmental factors, chromosomal abnormalities, p53 mutation are common risk factors [72] | Depending on the stage, chemotherapy, radiation therapy, surgery (amputation, grafting, local excision) [281] | Vasculature is critical for tumor survival, osteosarcoma generally involves downregulation of anti-angiogenic factors [73, 74] |
VEGF vascular endothelial growth factor