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The article titled "[Retracted] Association between vascular endothelial growth factor gene polymorphisms and the risk of osteonecrosis of the femoral head: Systematic review" has been retracted due to the authors' reference to a non-existent test in the publication. The authors were given an opportunity to respond to this concern but did not provide a reply within the requested time-frame. As a result, the editor has decided to retract the paper from the journal. We apologize for any inconvenience caused. [Extracted from the article]

Background/objective: A prospective cohort study aimed to evaluate the clinical efficacy of a specific vasoactive herbal formula, Huo Xue Tong Luo capsule (HXTL capsule), for the treatment of patients with asymptomatic osteonecrosis of femoral head (ONFH)., Methods: We evaluated a clinical trial of 55 patients (59 hips) with asymptomatic ONFH (no joint collapse) evaluated by Steinberg staging system and necrosis range classification criteria. Then, they were given HXTL capsule under specific protocol. Among them, 39 males and 16 females with an average age of 36.4 ± 10.1 years were followed up for an average of 4.38 years during treatment. The aggravation of clinical and imaging results was assessed by initial pain and joint collapse. The clinical and imaging outcomes of these patients were compared with those of a historical control group from the literature under critical inclusion criteria., Results: At the latest follow-up, initial pain occurred in five of 59 (8.5%) hips of patients taking HXTL capsule compared with 31 of 81 (38.3%) controls ( p  < 0.001), and joint collapse occurred in 13 of 59 (22.0%) hips of patients taking HXTL capsule compared with 26 of 81 (32.1%) controls ( p  < 0.001). There was no association between joint collapse and multiple key factors of ONFH. Only the location of type C2 necrotic lesions (hazard ratio, 4.12; 95% confidence interval, 2.64-18.91) and the extent of large necrotic lesions (hazard ratio, 3.39; 95% confidence interval, 1.43-16.21) predicted joint collapse., Conclusion: As an agent formulated by vasoactive herbals, HXTL capsule with specific protocol is an effective medicine for relieving hip pain and preventing joint collapse in patients with asymptomatic ONFH., The Translational Potential of This Article: The translation potential of this prospective cohort study is that the initially officially approved clinical indication for HXTL capsule for treatment of ONFH is due to its possible effect of revascularization on angiogenesis of necrosis. It is has been now proven to be effective for a new clinical application.

Emerging evidence has shown that vascular endothelial growth factor (VEGF) gene polymorphisms are the key initiators that regulate the expression of the VEGF protein, which has a vital role in osteonecrosis of the femoral head (ONFH). The aim of the present study was to investigate whether polymorphisms of the VEGF genes are associated with the occurrence of ONFH. A comprehensive search was performed on MEDLINE, Embase, Web of Science and China National Knowledge Infrastructure databases before June 2015. Meta-analyses were carried out for the VEGF gene -634G/C polymorphisms (single-nucleotide polymorphism with 3 eligible studies). The pooled odds ratios with 95% confidence intervals (CIs) were used to evaluate the strength of the association. All the eligible studies, involving 1,564 individuals, were identified. According to the inclusion criteria, 3 case-control studies were finally included in the meta-analysis. The present meta-analysis indicates that the VEGF gene -634G/C polymorphism [CC+GC vs. GG: Response rate (RR)=0.79; 95% CI, 0.67-0.92; GG vs. GC: RR=0.83; 95% CI, 0.72-0.97; GG vs. CC: RR=0.82; 95% CI, 0.72-0.93] is associated with the occurrence of ONFH, and the association with the male subgroup (RR=0.78; 95% CI, 0.65-0.94; P=0.009) is more evident. In conclusion, the present meta-analysis suggests that the VEGF gene -634G/C polymorphism has a significant association with ONFH occurrence among the investigated patients (P<0.01).