Analysis of the efficacy of autologous adipose-derived stromal vascular fraction and calcium phosphate bone cement combined with core decompression in patients with femoral head necrosis: a retrospective study.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

BACKGROUND: Osteonecrosis of the femoral head (ONFH) is a progressive disorder characterized by impaired perfusion, inflammation, neural dysregulation, and structural failure of the femoral head. While core decompression (CD) is commonly used for joint preservation, its effectiveness remains limited, particularly in the absence of adequate structural support and biological modulation. Adipose-derived stromal vascular fraction (SVF) has emerged as a potential biological adjunct due to its angiogenic, immunomodulatory, and regenerative properties. This study aimed to evaluate the clinical outcomes of combining autologous SVF and calcium phosphate cement (CPC) with CD in patients with ONFH. METHODS: We retrospectively analyzed 148 patients (219 hips) with ONFH treated between 2009 and 2022. Eighty-five hips underwent CD alone (CD group), and 134 hips received SVF combined with CPC and CD (SVF + CPC + CD group). Radiographic progression and conversion to total hip arthroplasty (THA) were assessed according to the Association Research Circulation Osseous (ARCO) staging system. Hip survival was evaluated using Kaplan–Meier analysis, and multivariable Cox proportional hazards regression was performed to identify factors associated with conversion to THA. Clinical outcomes were assessed using the Harris Hip Score (HHS), visual analogue scale (VAS), and the 36-Item Short Form Health Sur

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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