Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (635 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
The longest and largest bone of the skeleton, it is situated between the hip and the knee.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Femurs; Trochanter; Trochanters; Greater Trochanter; Greater Trochanters; Trochanter, Greater; Trochanters, Greater; Lesser Trochanter.
Where it fits in the MeSH classification
- Broader topics
- Bones of Lower Extremity
- Narrower topics
- Femur Head; Femur Neck
Research landscape
PubMed indexes 66,226 records tagged with the MeSH heading “Femur” (counts retrieved 2026-10-31). 10,910 of them (16.5%) were published from 2020 onward, and the busiest period so far is through 1999 with 23,474 records.
Reviews account for 2,863 records (4.3%) and meta-analyses for 446. Randomized controlled trials number 1,304 (2.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 23,474 |
| 2000-2009 | 12,729 |
| 2010-2019 | 19,113 |
| 2020 onward | 10,910 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 2,863 | 4.3% |
| Meta-analyses | 446 | 0.7% |
| Randomized controlled trials | 1,304 | 2.0% |
Method: PubMed query "Femur"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in anatomy and physiology
Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Advances in the mechanism for steroid-induced osteonecrosis of the femoral head | 2026 | Review article Design not recorded in structured metadata | 7 | cc by PMID 41680130 · DOI · PMC12902040 |
| Graft incorporation and stem subsidence in femoral impaction bone grafting for revision hip arthroplasty: a systematic review and meta-analysis of 2514 hips | 2025 | Meta-analysis Design not recorded in structured metadata | 3 | cc by PMID 41222718 · DOI · PMC12611990 |
| Jianpi-Huogu Prescription Repairs Nontraumatic Osteonecrosis of the Femoral Head by Inhibiting NAMPT/STK11/HMGCR/ACAT1 Axis-Mediated Lipid Production | 2025 | Research article Design not recorded in structured metadata | 3 | cc by PMID 40988117 · DOI · PMC12457209 |
Advances in the mechanism for steroid-induced osteonecrosis of the femoral head [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating condition resulting from the use of glucocorticoids, commonly prescribed for immune-related and inflammatory diseases.
- Closing excerpt
- Additionally, it highlights emerging therapeutic strategies that potentially pave the way for more effective treatments in the future.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (123 words)
Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating condition resulting from the use of glucocorticoids, commonly prescribed for immune-related and inflammatory diseases. Understanding the mechanisms driving SONFH remains a significant challenge, complicating efforts to prevent and treat the condition. While genetic predispositions, impaired blood supply, and metabolic changes are recognized contributors, the complex interplay between these factors is not yet fully understood. Recent research has shed light on the pathogenesis of SONFH, exploring it from multiple perspectives, including tissue-level damage, cellular dysfunction, and molecular pathways. This review summarizes these recent advancements, providing an integrated understanding of the onset and progression of the condition. Additionally, it highlights emerging therapeutic strategies that potentially pave the way for more effective treatments in the future.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41680130 · DOI · PMC12902040
Graft incorporation and stem subsidence in femoral impaction bone grafting for revision hip arthroplasty: a systematic review and meta-analysis of 2514 hips [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundFemoral impaction bone grafting (IBG) is an established technique for managing severe bone loss during revision total hip arthroplasty (rTHA).
- Closing excerpt
- Neither graft type, stem design, age, nor preoperative bone loss classification significantly influenced subsidence or incorporation variability.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (312 words)
BackgroundFemoral impaction bone grafting (IBG) is an established technique for managing severe bone loss during revision total hip arthroplasty (rTHA). Despite its widespread use, the extent of graft incorporation and the degree of stem subsidence remain incompletely characterized. This systematic review evaluates graft incorporation and stem subsidence outcomes in femoral IBG for rTHA.MethodsA systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Three databases were searched from inception to December 31, 2024, for studies involving rTHA with femoral IBG and a minimum follow-up of 12 months. Meta-analyses focused on graft incorporation rates and stem subsidence. Subgroup analysis examined age, pre-operative bone loss, graft type, follow-up duration and other predictors. Heterogeneity was assessed using the I2 statistic under a random-effects model.ResultsA total of 33 studies (2395 patients; 2514 hips) met inclusion criteria. The mean patient age was 66 years (range 22-95 years), with a male-to-female distribution of 48%/52%. The hips-weighted mean follow-up was 8.8 years (range of study means 1.1-17.0 years). Overall, the pooled proportion of graft incorporation was 76%; 95% confidence interval (CI) 63%-85%. The weighted average subsidence across all studies was 2.5 mm (95% CI 1.7-3.1 mm). Subgroup analyses showed no statistically significant differences in graft incorporation rates based on graft type (p = 0.399), age (p = 0.742), or follow-up duration (p = 0.560). Similarly, stem subsidence did not differ significantly by gender (p = 0.181), graft type (p = 0.460), or age (p = 0.301). Preoperative bone loss classification (Endo-Klinik, Paprosky) was not associated with notable differences in graft incorporation (p = 0.263) or subsidence (p = 0.486).ConclusionsFemoral IBG for rTHA demonstrates variable but generally favorable graft incorporation rates, averaging 76% (95% CI 63%-85%), with a mean stem subsidence of 2.5 mm at mid-to-long-term follow-up. Neither graft type, stem design, age, nor preoperative bone loss classification significantly influenced subsidence or incorporation variability.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41222718 · DOI · PMC12611990
Jianpi-Huogu Prescription Repairs Nontraumatic Osteonecrosis of the Femoral Head by Inhibiting NAMPT/STK11/HMGCR/ACAT1 Axis-Mediated Lipid Production [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Jianpi-Huogu Prescription (JHP), integrating the classic Chinese herbal formulas Linggui-Zhugan Decoction and Si-Wu Decoction, has shown clinical efficacy in treating early nontraumatic osteonecrosis of the femoral head (NONFH).
- Closing excerpt
- In conclusion, JHP ameliorates early NONFH by regulating lipid metabolism, improving hypercoagulability, and restoring bone homeostasis through the NMNAT1/NMNAT3/NAMPT/STK11/HMGCR/ACAT1 axis.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (200 words)
Jianpi-Huogu Prescription (JHP), integrating the classic Chinese herbal formulas Linggui-Zhugan Decoction and Si-Wu Decoction, has shown clinical efficacy in treating early nontraumatic osteonecrosis of the femoral head (NONFH). In this study, 299 chemical constituents of JHP were identified using ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry. Pharmacological evaluations in rats with early NONFH demonstrated that JHP attenuated femoral head pathological changes, improved gait parameters, increased mechanical pain thresholds, reduced serum levels of triglycerides, total cholesterol, low-density lipoprotein, very-low-density lipoprotein, and the TXB₂/6-keto-PGF₁α ratio while elevating high-density lipoprotein, decreased serum inflammatory cytokines (IL-1β, IL-6, TNF-α) and the RANKL/OPG ratio, and restored bone trabecular morphology and reduced the number of bone marrow adipocytes. Mechanistically, through transcriptomic profiling, network calculations and experimental validation, JHP downregulated NMNAT1, NMNAT3, and NAMPT in the femoral head, thereby reducing NAD+ synthesis, increased ATP production (evidenced by a decreased ADP/ATP ratio) and upregulated STK11 expression, activated p-HMGCR while suppressing ACAT1 thus inhibiting cholesterol synthesis and lipid accumulation, and surface plasmon resonance confirmed direct binding of its active components (ligustilide, 5,6,4'-trihydroxy-7,3'-dimethoxyflavone, (Z)-3-butylidenephthalide, senkyunolide H, ferulic acid, guanosine) to NMNAT1. In conclusion, JHP ameliorates early NONFH by regulating lipid metabolism, improving hypercoagulability, and restoring bone homeostasis through the NMNAT1/NMNAT3/NAMPT/STK11/HMGCR/ACAT1 axis.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40988117 · DOI · PMC12457209
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment [4]
- Research article Osteonecrosis of the Femoral Head [5]
- Research article Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly [6]
- Research article Femoral anteversion: significance and measurement [7]
- Research article The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: 2019 ISCD Official Position [8]
- Research article Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress [9]
References
- Zhou R, Bian Y, Cai X, Sun H, Lv Z, Xu Y, et al.. Advances in the mechanism for steroid-induced osteonecrosis of the femoral head. . 2026. PMID 41680130 · DOI · PMC12902040
- Klimko A, Andronic O, Lu VYZ, Dimitriou D, Hoch A, Zingg PO. Graft incorporation and stem subsidence in femoral impaction bone grafting for revision hip arthroplasty: a systematic review and meta-analysis of 2514 hips. . 2025. PMID 41222718 · DOI · PMC12611990
- Li T, Ma Z, Gao S, Zhang C, Jia Y, Feng H, et al.. Jianpi-Huogu Prescription Repairs Nontraumatic Osteonecrosis of the Femoral Head by Inhibiting NAMPT/STK11/HMGCR/ACAT1 Axis-Mediated Lipid Production. . 2025. PMID 40988117 · DOI · PMC12457209
- Hines JT, Jo WL, Cui Q, Mont MA, Koo KH, Cheng EY, et al.. Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment. J Korean Med Sci. 2021. PMID 34155839 · DOI · PMC8216992
- Cohen-Rosenblum A, Cui Q. Osteonecrosis of the Femoral Head. Orthop Clin North Am. 2019. PMID 30850073 · DOI
- Panteli M, Rodham P, Giannoudis PV. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury. 2015. PMID 25597514 · DOI
- Scorcelletti M, Reeves ND, Rittweger J, Ireland A. Femoral anteversion: significance and measurement. J Anat. 2020. PMID 32579722 · DOI · PMC7542196
- Weber DR, Boyce A, Gordon C, Högler W, Kecskemethy HH, Misra M, et al.. The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: 2019 ISCD Official Position. J Clin Densitom. 2019. PMID 31421951 · DOI · PMC7010480
- Hernigou P, Trousselier M, Roubineau F, Bouthors C, Chevallier N, Rouard H, et al.. Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress. Clin Orthop Surg. 2016. PMID 26929793 · DOI · PMC4761591
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
See how EvidenceLib is built. Spotted an error? Email support@evidencehelix.com.
Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.