Objective To summarize recent research advances of hydrogels for the treatment of osteonecrosis of the femoral head (ONFH). Methods The literature on hydrogels for treatment of ONFH at home and abroad in recent years was extensively reviewed, and the fundamental research and clinical application were summarized and analyzed. Results In the field of fundamental research, functionalized hydrogels (including thermosensitive, oxygen-controlled release, and ion-doped types) demonstrate significant advantages in achieving targeted delivery, controlled release, and microenvironment regulation. Particularly, the development of novel material systems, such as composite scaffold systems, gene-activated hydrogels, and engineered exosomes, has further enhanced treatment precision and biological efficacy. In terms of clinical application, the materials like recombinant human fibroblast growth factor 2 (rhFGF-2) gelatin hydrogels have been validated in multiple trials, showing promising joint preservation rates and bone regeneration capabilities. This opens a promising new clinical pathway for hip-preserving treatment of ONFH. Among these, hydrogel-based multilevel composite scaffolds represent the most promising materials for clinical translation. ConclusionHydrogel systems, by synergistically regulating osteogenesis, angiogenesis, and immunomodulation, and leveraging the unique advantages of functionalized materials in precise drug control and microenvironment regulation, have evolved into advanced platforms for the comprehensive treatment of ONFH. Among them, rhFGF-2 gelatin hydrogels, with their remarkable clinical efficacy, offer a new strategy of significant translational value for hip-preserving therapy.
Objective To summarize research progress on application of Cup-cage reconstruction in revision of chronic pelvic discontinuity (CPD) in patients undergoing total hip arthroplasty (THA). Methods Relevant literature at home and abroad in recent years was reviewed to summarize the principles of the Cup-cage reconstruction, preoperative patient assessment, intraoperative skills, clinical and radiological effectiveness, limitations, and postoperative complications. Results For the treatment of CPD, the Cup-cage reconstruction achieved long-term acetabular cup bone ingrowth, CPD healing, and biologic fixation of the prosthesis by restoring pelvic continuity. Preoperative evaluation of the surgical site and general condition is necessary. The main intraoperative objectives are to reconstruct pelvic continuity, restore the center of rotation of the hip, and avoid neurovascular injury. Current studies have demonstrated significant clinical and radiological effectiveness as well as acceptable prosthesis survival rates after operation. Nevertheless, there is a lack of evidence regarding the staging of CPD, the optimal surgical approach and internal fixation, and the factors influencing postoperative prosthesis survival remain undefined. Conclusion Cup-cage reconstruction can be an effective treatment for CPD after THA, but there is still a need to explore CPD staging, Cup-cage approach and internal fixation, and influencing factors on prosthesis survival.