Emoto et al found that CSF-1 regulates osteoclastogenesis mediated by osteoblasts and plays a significant role in bone development.[39] Furthermore, marrow adipogenic lineage precursors are the main source of CSF1 in bone and one of the main cell types driving bone resorption, according to research by Zhong et al osteosclerosis and osteocyte abnormalities result from the inhibition of bone resorption caused by a CSF1 deficit.[40] Current research on the relationship between CSF1 and osteonecrosis is limited; our study demonstrates a negative causal association between CSF1 and osteonecrosis. The gene discussed is CSF1; the disease is osteonecrosis.