Decreased osteogenic differentiation of mesenchymal stem cells in alcohol-induced osteonecrosis.

We postulated that osteogenic and adipogenic differentiation ability of the mesenchymal stem cells isolated from the bone marrow could be altered in patients with alcohol-induced osteonecrosis of the femoral head. To examine this hypothesis, we investigated the differentiation ability of the mesenchymal stem cells isolated from the bone marrow from the proximal end of the femur during hip replacements in patients with alcohol-induced osteonecrosis of the femoral head and compared it with the differentiation ability of patients with femoral neck fractures. Marrow was collected from the proximal femurs of 33 patients having hip replacement for either alcohol-induced osteonecrosis of the femoral head or femoral neck fractures. The mesenchymal stem cells were isolated and the culture was expanded from the marrow. The cell populations were compared in terms of the doubling time and the differentiation ability to the osteoblasts and adipocytes. The cells obtained from the patients with alcohol-induced osteonecrosis of the femoral head showed a reduced ability to differentiate the osteogenic lineages compared with the cells obtained from the patients with femoral neck fractures. Such changes may play a role in the development of alcohol-induced osteonecrosis of the femoral head. The altered function of mesenchymal stem cells can be responsible for the pathogenesis of osteonecrosis.