Prospective cohort study of 189 hips in 116 patients treated with core decompression plus concentrated autologous iliac crest bone marrow grafting for femoral head osteonecrosis, with 5–11 year follow-up. Evaluates whether adding quantified progenitor cells to standard decompression improves outcomes, and whether cell dose and disease stage predict failure.
When considering core decompression for osteonecrosis, stage and etiology are inseparable from prognosis: operate before collapse (Stage I–II) and expect ~6% conversion to THA; wait until Stage III–IV and that rate jumps to ~57%.
In patients with steroid or transplant-related osteonecrosis, expect a depleted marrow with fewer harvestable progenitors — bone marrow augmentation may still help, but lower cell yields mean lower biological reserve for repair.
Prospective cohort study of 189 hips in 116 patients treated with core decompression plus concentrated autologous iliac crest bone marrow grafting for femoral head osteonecrosis, with 5–11 year follow-up. Evaluates whether adding quantified progenitor cells to standard decompression improves outcomes, and whether cell dose and disease stage predict failure.
When considering core decompression for osteonecrosis, stage and etiology are inseparable from prognosis: operate before collapse (Stage I–II) and expect ~6% conversion to THA; wait until Stage III–IV and that rate jumps to ~57%.
In patients with steroid or transplant-related osteonecrosis, expect a depleted marrow with fewer harvestable progenitors — bone marrow augmentation may still help, but lower cell yields mean lower biological reserve for repair.