Coagulation Abnormalities in Osteonecrosis and Bone Marrow Edema Syndrome

Educational Objectives As a result of reading this article, physicians should be able to: 1. Identify relevant coagulation laboratory parameters at the site of osteonecrosis and bone marrow edema syndrome. 2. Understand the mechanisms of fibrinolysis and its possible role in the emergence of osteonecrosis and bone marrow edema syndrome. 3. Understand the mechanisms of thrombophilia and its possible role in the emergence of osteonecrosis and bone marrow edema syndrome. 4. Increase their knowledge about diagnostic and therapeutic measures at the site of osteonecrosis and bone marrow edema syndrome when disturbed coagulation laboratory parameters are present. The aim of this review was to provide information about the variety of thrombophilic and hypofibrinolytic markers that are possible risk factors for the development of osteonecrosis and bone marrow edema syndrome. A total of 48 parameters were identified in 45 studies that included 2163 patients. The most frequently reported laboratory findings included altered serum concentrations of lipoproteins, decreased concentration and function of fibrinolytic agents, increased levels of thrombophilic markers, and several single nucleotide polymorphisms. Despite inhomogeneities in reported parameters, results, patients’ collectives, and treatment strategies, these data suggest that coagulation abnormalities may play an important role in the emergence of osteonecrosis and bone marrow edema syndrome.