Triple-Modal Therapy in Early-Stage Femoral Head Osteonecrosis (TM-ONFH)

Triple-Modal Therapy (Core Decompression, Stromal Vascular Fraction, and Hyperbaric Oxygen Therapy) is Associated Improved Clinical and Radiologic Outcomes in Early-Stage Osteonecrosis of the Femoral Head: Two-Year Follow-Up of 24 Patients

This retrospective observational study evaluates the clinical and radiological outcomes of patients with early-stage osteonecrosis of the femoral head treated with a combination of core decompression, stromal vascular fraction (SVF), and hyperbaric oxygen therapy (HBOT). A total of 24 patients were included and followed for two years. The aim of this study is to assess the effectiveness of this combined therapeutic approach in improving clinical outcomes and preventing disease progression.

Osteonecrosis of the femoral head (ONFH) is a progressive disease that can lead to femoral head collapse and the need for total hip arthroplasty. Joint-preserving treatments are particularly important in early-stage disease. Core decompression is a widely used technique to reduce intraosseous pressure and improve blood flow. Stromal vascular fraction (SVF), which contains mesenchymal stem cells, may enhance bone regeneration. Hyperbaric oxygen therapy (HBOT) has been shown to improve tissue oxygenation and promote healing.

In this study, patients with early-stage ONFH who underwent a combined treatment of core decompression, SVF injection, and HBOT were retrospectively analyzed. Clinical outcomes were assessed using functional scores, and radiological progression was evaluated during a two-year follow-up period. The purpose of this study is to determine whether this triple-modal therapy provides improved outcomes compared to conventional treatment approaches.

Inclusion Criteria:

• Patients diagnosed with Ficat-Arlet Stage II osteonecrosis of the femoral head
• Patients treated with combined core decompression, stromal vascular fraction (SVF), and hyperbaric oxygen therapy (HBOT)
• Age between 18 and 65 years
• Patients who completed all components of the treatment protocol
• Minimum follow-up duration of 24 months

Exclusion Criteria:

• Patients with advanced-stage osteonecrosis (Ficat-Arlet Stage III-IV)
• Patients with a history of previous hip surgery
• Patients who previously received hyperbaric oxygen therapy for ONFH
• Patients who received prior cellular therapies (e.g., stem cell therapy or PRP) in the hip joint
• Patients with incomplete medical records
• Patients who did not complete the full treatment protocol
• Patients with follow-up duration less than 24 months