Association between bone trace metal accumulation and idiopathic aseptic osteonecrosis of the femoral head in a mining region of Katanga (DR Congo)

This study provides the first direct evidence that chronic bone accumulation of lead and cobalt is strongly associated with idiopathic ONFH in a mining-exposed African population. These findings highlight the urgent need for environmental monitoring, targeted public health interventions, and early clinical surveillance in high-risk regions.