Clinical Trials Study
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World J Clin Cases. Mar 6, 2022; 10(7): 2138-2146
Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2138
Previously unexplored etiology for femoral head necrosis: Metagenomics detects no pathogens in necrotic femoral head tissue
Chao Liu, Wei Li, Chao Zhang, Feng Pang, Da-Wei Wang
Chao Liu, Wei Li, Da-Wei Wang, Department of Orthopedics, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Chao Liu, Chao Zhang, Department of Orthopedics, Shandong The First Medical University, Taian 271016, Shandong Province, China
Feng Pang, Department of Clinical Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
Author contributions: Wang DW and Pang F study concept and design; Wang DW study supervision; Pang F administrative, technical, and material support; Liu C and Li W analysis and interpretation of data; Zhang C acquisition of data; Liu C drafting of the manuscript; Zhang C, Pang F, and Liu C critical revision of the manuscript for important intellectual content; Zhang C statistical analysis; Wang DW and Pang F contributed equally to this study; all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Liaocheng People's Hospital (Approval No.2018010).
Clinical trial registration statement: This study was conducted as part study registered with the Chinese Clinical Trial Registry (ChiCTR-RRC-16010123).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
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: Da-Wei Wang, MD, PhD, Director, Professor, Department of Orthopedics, Liaocheng People's Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. wangdaweisci@126.com
Received: September 30, 2021
Peer-review started: September 30, 2021
First decision: December 4, 2021
Revised: December 17, 2021
Accepted: January 20, 2022
Article in press: January 20, 2022
Published online: March 6, 2022
Processing time: 152 Days and 19.5 Hours
Core Tip

Core Tip: Osteonecrosis of the femoral head (ONFH) is a frequent and refractory disease whose pathogenesis has not been elucidated. Infection and other factors that reduce the local blood supply can lead to osteonecrosis. We performed culture and metagenomic sequencing to examine the presence of pathogens in necrotic femoral head tissue. The results confirmed the absence of viruses, fungi, parasites, or mycoplasma/chlamydia in the specimens, and no significant differences in bacterial distribution and suspected background microorganisms. Although we did not identify an ONFH-specific pathogen, our study lays the groundwork for future research on metagenomics of bone pathogens.