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  4. Core decompression and autologous bone marrow concentrate for treatment of femoral head osteonecrosis: a randomized prospective study

Core decompression and autologous bone marrow concentrate for treatment of femoral head osteonecrosis: a randomized prospective study

Orthopedic Reviews, 2016 · DOI: 10.4081/or.2016.6162 · Published: January 1, 2016

Regenerative MedicineOrthopedicsMusculoskeletal Medicine

Simple Explanation

This study investigates the safety and effectiveness of injecting bone marrow concentrate during core decompression for femoral head osteonecrosis. The study involved 24 patients who were followed for two years to assess clinical and radiological outcomes. The results showed pain reduction and functional improvement, but no significant difference between those who received bone marrow concentrate and those who didn't.

Study Duration
2 years
Participants
24 consecutive patients (25 hips) with non-traumatic femoral head necrosis
Evidence Level
Level 1, Randomized prospective clinical trial

Key Findings

  • 1
    Significant pain reduction and functional improvement were observed postoperatively in both groups.
  • 2
    There was no statistically significant difference in clinical outcomes between the core decompression alone and core decompression with BMAC groups.
  • 3
    The addition of bone marrow concentrate did not significantly improve bone regeneration or clinical outcomes in the short term.

Research Summary

This study evaluated the use of bone marrow aspirate concentrate (BMAC) in conjunction with core decompression for the treatment of femoral head osteonecrosis (FHN). The trial found that while core decompression resulted in pain relief and functional improvement, the addition of BMAC did not provide a significant additional benefit. The study concludes that for ARCO II FHN, core decompression is beneficial, but the short-term benefits of adding BMAC are not detectable in this trial.

Practical Implications

Surgical Procedure

Core decompression remains a viable option for treating ARCO II FHN.

Bone Marrow Use

The added benefit of bone marrow concentrate is questionable in the short term.

Further Research

Longer-term studies with larger sample sizes are necessary to validate these results.

Study Limitations

  • 1
    Small sample size (24 patients)
  • 2
    Short follow-up period (two years)
  • 3
    Restrictive inclusion criteria (ARCO II only)

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