Ozone Therapy in Femoral Head Necrosis: A Perspective on Biomarker-Guided Treatment Rationalization and Mechanistic Exploration

Liang Zhang¹Qing-hua Wang²Liang-liang He³Yumei Ding¹Xiao-dong Wang¹Zhi-feng Zhang¹Mu-han Na¹Yi-fan Zhao⁴Yi Qiu^1*Xu-ting Zhao^1*

• ¹The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
• ²People’s Hospital of Oedos Dongsheng District, Oedos, China
• ³Capital Medical University Xuan Wu Hospital, Beijing, China
• ⁴Inner Mongolia Medical University, Hohhot, China

Femoral head necrosis (FHN) is a progressive and disabling disorder caused by compromised blood supply to the femoral head. Current treatments primarily aim to slow progression. However, they often fail to reverse early-stage necrosis or reliably prevent disease advancement. Importantly, most approaches lack precise molecular targets for early intervention. Ozone therapy has emerged as a potential option because of its pleiotropic biological effects, such as modulating oxidative stress, improving microcirculation, and exerting anti-inflammatory activity. However, its mechanisms remain poorly understood. Clinical evidence is limited and inconsistent, and the absence of standardized protocols hinders evidence-based implementation. To address these gaps, this perspective proposes biomarkers as a translational bridge linking ozone-induced biological responses to FHN pathology. We further outline a dynamic, biomarker-guided framework through which ozone therapy can evolve from an empirical intervention into a mechanism-informed, personalized, and more standardized precision strategy. This approach offers a scientifically grounded pathway for advancing the clinical management of FHN.