Biological Augmentation With Retro-Drilling Core Decompression in Early Stage of Femoral Head Avascular Necrosis.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• 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)

Osteonecrosis of the femoral head can lead to end-stage osteoarthritis when left untreated. The incidence has been on the rise since the onset of the COVID-19 pandemic. Core decompression of the femoral head is usually the first line of surgical treatment when conservative options fail. Additional biologic support (e.g., bone marrow aspiration concentrates, mesenchymal stem cell derivatives, adipose-derived stromal vascular fraction) has been shown to augment the effects of core decompression alone, but the nature and amount of this additional support is still a topic for debate. This technique describes a surgical approach featuring debridement through retro-drilling, core decompression, and biologic augmentation with stromal vascular fraction and bone marrow aspiration concentrate on the early stages of osteonecrosis of the femoral head.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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