Oxidative stress drives steroid-induced necrosis of femoral head; antioxidants may help maintain redox balance.

This systematic review investigated the mechanisms of different classes of antioxidants in the context of steroid-induced necrosis of the femoral head (SINFH). The study population, sample size, and specific setting were not reported. The review focused on how oxidative stress affects bone metabolic balance, inflammatory responses, vascular injury, and apoptosis, which can accelerate SINFH progression.

The intervention or exposure involved direct free radical scavengers, enzyme modulators, and natural compounds such as vitamin C, vitamin E, N-acetylcysteine, resveratrol, and curcumin. A comparator was not reported. The main finding indicated that oxidative stress is crucial for the occurrence and development of SINFH. Consequently, maintaining a dynamic balance between oxidation and antioxidation may be more important than completely suppressing redox reactions.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Key limitations include the absence of reported population details, sample sizes, primary outcomes, and follow-up information. Funding or conflicts of interest were not reported. The certainty of the findings was not reported.

The practice relevance suggests that inhibiting oxidative stress has positive implications for the treatment of steroid-induced avascular necrosis. However, clinicians should interpret these findings with caution due to the incomplete data regarding patient populations and specific clinical outcomes.