Objective To review the research progress of subtype H vessels in the occurrence and development of osteonecrosis of the femoral head (ONFH).Methods The relevant domestic and foreign literature was extensively reviewed. The histological features, biological mechanism of subtype H vessels involved in promoting of osteogenesis, and the role and application of the subtype H vessels in ONFH were summarized.Results The subtype H vessel is a newly discovered bone vessel, mainly distributed in metaphysis and subperiosteum, highly expressing endomucin and CD31. The subtype H vessel has a dense arrangement of Runx2+ early osteoprogenitors, collagen type Ⅰα+ osteoblast cells, and Osterix+ osteoprogenitors that have the ability to induce osteogenesis and angiogenesis. Factors such as platelet-derived growth factor BB, slit guidance ligand 3, hypoxia inducible factor 1α, Notch signaling pathway, and vascular endothelial growth factor are involved in the mechanism of subtype H vessels in promoting osteogenesis.Conclusion Subtype H vessels play an important role in the regulation of angiogenesis and osteogenesis during bone tissue repair and reconstruction. The discovery of subtype H vessels provides new insights into the molecular and cellular mechanisms of osteogenesis and angiogenesis coupling. In the future, new techniques targeting the regulation of subtype H blood vessels may become a promising method for the treatment of ONFH.
MA Jinhui, REN Yansong, WANG Bailiang, SUN Wei, YUE Debo, WANG Weiguo. Progress of developmental mechanism of subtype H vessels in osteonecrosis of the femoral head. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(11): 1486-1491. doi: 10.7507/1002-1892.202103159