ReviewClinical rheumatology2026
Avascular necrosis in antiphospholipid syndrome: pathophysiology, risk factors, and management.
Review in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
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Abstract
backgroundAntiphospholipid syndrome (APS) is an autoimmune disorder characterized by thrombosis and pregnancy morbidity in the presence of antiphospholipid antibodies, which include lupus anticoagulant, anticardiolipin, and anti-β2 glycoprotein I. The updated 2023 ACR/EULAR classification criteria recognize microvascular features of APS but not orthopedic complications. Among these, avascular necrosis (AVN) is an uncommon and underrecognized manifestation, characterized by ischemic death of bone tissue, most often affecting the femoral head, knee, talus, and humeral head. The link between APS and AVN remains unclear and warrants further review.
objectivesTo explore the association between APS and AVN, focusing on its pathophysiology, prevalence, risk factors, clinical presentation, and management strategies.
methodsA comprehensive search was performed across medical databases, including PubMed, Medline, and Google Scholar, using relevant keywords.
resultsAVN is a rare but significant complication of APS, with prevalence ranging from 0.9 to 20%, depending on the study design and population analyzed. The pathogenesis is primarily attributed to microvascular thrombosis and hypercoagulability caused by antiphospholipid antibodies. Identified risk factors include prolonged glucocorticoid use, thrombocytopenia, pregnancy, and underlying microvascular abnormalities. Early detection via MRI and timely interventions, such as anticoagulation therapy, lifestyle modifications, and surgical procedures, improve patient outcomes and prevent disease progression.
conclusionsUnderstanding the multifaceted nature of AVN in APS is crucial for timely diagnosis and effective management. Further research is needed to establish clear preventative strategies and optimize long-term treatment protocols, ultimately improving patient care and clinical outcomes.
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