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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2026; 17(2): 110517
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.110517
Published online Feb 18, 2026. doi: 10.5312/wjo.v17.i2.110517
Phosphatidylinositol-3-kinase/protein kinase B signaling dysregulation in steroid-induced osteonecrosis of the femoral head: A minireview of therapeutic implications
Ya-Nan Wang, Cheng-Xiang Pang, Lei Sun, Ran Sun, Feng-Ming Wang, Hong-Jiang Jiang, Department of Orthopedics, Shandong Wendeng Orthopedic Hospital, Weihai 264400, Shandong Province, China
Jun-Xia Jiang, Department of Pathology, Shandong Wendeng Orthopedic Hospital, Weihai 264400, Shandong Province, China
Author contributions: Jiang HJ designed the study; Wang YN and Pang CX performed the literature review and drafted the manuscript; Jiang JX, Sun L, and Sun R contributed to the data interpretation and critical revision of the manuscript; Wang FM assisted in the editing and formatting of the manuscript. All authors read and approved the final version of the manuscript.
Supported by Joint TCM Science and Technology Projects of National Demonstration Zones for Comprehensive TCM, No. GZY-KJS-SD-2023-031.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Jiang Jiang, MD, Professor, Department of Orthopedics, Shandong Wendeng Orthopedic Hospital, No. 1 Fengshan Road, Wendeng District, Weihai 264400, Shandong Province, China. wdzggys@163.com
Received: June 9, 2025
Revised: July 28, 2025
Accepted: November 24, 2025
Published online: February 18, 2026
Processing time: 241 Days and 12.2 Hours
Revised: July 28, 2025
Accepted: November 24, 2025
Published online: February 18, 2026
Processing time: 241 Days and 12.2 Hours
Core Tip
Core Tip: Steroid-induced osteonecrosis of the femoral head (SIONFH) is a debilitating disorder associated with prolonged glucocorticoid therapy. The phosphatidylinositol-3-kinase/protein kinase B signaling pathway plays a critical role in regulating the survival, differentiation, and angiogenesis of bone cells. This mini-review highlighted how glucocorticoid-induced dysregulation of the phosphatidylinositol-3-kinase/protein kinase B pathway in osteoblasts, osteoclasts, mesenchymal stem cells, and endothelial cells contributed to the pathogenesis of SIONFH. We reviewed emerging therapeutic strategies targeting this pathway and provided new insights into potential interventions for early-stage SIONFH.