Pathogenesis of Osteonecrosis
Etiologic factors initiate hemostasis directly or trigger a cascade resulting in hemostasis. Histologic findings indicate that the final common pathway for the various inciting factors involves local intravascular coagulation and resultant tissue ischemia. The result is that of cancellous bone and bone marrow death. With subchondral cancellous bone death, collapse of the articular surface may or may not occur, depending on the extent of involvement.
