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RESEARCH Open Access© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 /.Pang et al. Journal of Orthopaedic Surgery and Research (2025) 20:724 https://doi.org/10.1186/s13018-025-06138-8Journal of Orthopaedic Surgery and Research*Correspondence:Zhentao Manmztqd1984@163.comDandan Wangddwang@sdfmu.edu.cnWei Ligreatli2000@163.comFull list of author information is available at the end of the articleAbstractBackground Osteonecrosis of the femoral head (ONFH) is a progressive, debilitating orthopedic condition that primarily results from compromised vascular supply. Chronic alcohol intake is a well-established non-traumatic etiological factor in ONFH. Despite the increasing global research on ONFH, a bibliometric analysis using explicit literature searches in Web of Science reveals that no studies have specif i cally focused on alcohol-induced osteonecrosis of the femoral head (AONFH). This study aims to provide a comprehensive overview of the global research landscape of AONFH, identifying key research hotspots, emerging trends, and future directions using both qualitative and quantitative bibliometric methods.Methods The Web of Science Core Collection was systematically searched for publications from 1998 to 2024 related to AONFH and identif i ed 353 relevant articles. RStudio and Bibliometrix 4.1.0 were used to analyze annual publication volume and cited papers. VOSviewer was employed to conduct bibliographic coupling analysis and CiteSpace was used to analyze countries, institutions, authors, journals, and keywords. Microsoft Excel 2019 was utilized to perform linear regression on annual publication volume.Results Clinical Orthopaedics and Related Research had the highest number of publications and citations. Chinese scholars published the most, while U.S.-based research received greater international recognition. Shanghai Jiao Tong University ranked fi rst in institutional output. Sugano Nobuhiko and Fukushima Wakaba were identif i ed as the most inf l uential scholars. The main research hotspots—as measured by keyword centrality and frequency—were “risk factors” and “core decompression,” followed by “total hip arthroplasty,” “alcohol intake,” and “steroid-induced osteonecrosis.” Over time, the focus of AONFH research has shifted from broader themes such as “disease,” “smoking,” “occupational status,” and “idiopathic osteonecrosis” to more specialized areas including “gene expression,” “polymorphisms,” “steroid-induced osteonecrosis,” and “risk factors.”The bibliometric and visualization analysis of alcohol-induced osteonecrosis of the femoral head: research trends and future directions (1998–2024)Kai Pang 1,2 , Huiying Li 3 , Haifeng Chen 4 , Zhentao Man 1,2,5* , Dandan Wang 3* and Wei Li 1,2*