Spicer Seth, Brancaccio Hanna, Mahmud Do Rahyan, Goich Do Kenneth, Raja Do Altamash
Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA.
Futures Forward Research Institute, Toms River, NJ, USA.
J Orthop. 2026 Feb 11;75:256-261. doi: 10.1016/j.jor.2026.02.026. eCollection 2026 May.
There has been a recent increase in research focused on the combination of bone marrow aspirate concentrate (BMAC) with core decompression (CD) in the treatment of avascular necrosis of the femoral head (ANFH). However, the effects on patient functional outcomes have not specifically been determined.
This systematic review and meta-analysis of previous studies assess the functional outcomes of combined BMAC with CD compared to those of CD alone.
A systematic review and meta-analysis were conducted according to the PRISMA 2020 guidelines. Five online databases were searched using key terms to identify studies. Included in the analysis were randomized controlled trials (RCTs), retrospective reviews, and comparative studies that utilized BMAC with CD, BMAC, or CD as a treatment for ANFH and reported Harris Hip Scores (HHS) or Western Ontario and McMaster Universities Arthritis Index (WOMAC) pre- and post-treatment. 9 studies, evaluating 388 hips total, met inclusion criteria. HHS and WOMAC scores were compared between baseline and 4 ± 2.5 years post-treatment to represent overall physical functionality, pain severity, absence of deformity, range of motion, and stiffness.
Significant increases in HHS and decreases in WOMAC were found between baseline and 4 ± 2.5 years follow-up, representing an improvement in overall physical functionality, pain severity, absence of deformity, range of motion, and stiffness. A large effect size was found for CD with BMAC and CD alone, supporting utilization for both CD with BMAC or CD alone with no evidence that CD with BMAC is more effective.
Core decompression with and without BMAC shows large improvements in functional outcomes compared to baseline. Future high-quality RCTs would aid in elucidating our understanding of the effects of BMAC with CD on mitigating symptoms and increasing overall function.
最近，专注于将骨髓抽吸浓缩物（BMAC）与髓芯减压（CD）联合用于治疗股骨头缺血性坏死（ANFH）的研究有所增加。然而，对患者功能结局的影响尚未明确确定。
本对既往研究的系统评价和荟萃分析评估了BMAC与CD联合治疗与单纯CD治疗相比的功能结局。
根据PRISMA 2020指南进行系统评价和荟萃分析。使用关键词检索五个在线数据库以识别研究。纳入分析的是随机对照试验（RCT）、回顾性综述以及比较研究，这些研究将BMAC与CD联合、BMAC或CD用作ANFH的治疗方法，并报告治疗前后的Harris髋关节评分（HHS）或西安大略和麦克马斯特大学骨关节炎指数（WOMAC）。9项研究共评估了388个髋关节，符合纳入标准。比较基线与治疗后4±2.5年之间的HHS和WOMAC评分，以代表整体身体功能、疼痛严重程度、无畸形、活动范围和僵硬程度。
在基线与4±2.5年随访之间发现HHS显著增加，WOMAC显著降低，这表明整体身体功能、疼痛严重程度、无畸形、活动范围和僵硬程度有所改善。单独使用BMAC与CD联合使用时均发现较大的效应量，支持单独使用BMAC与CD联合或单独使用CD，没有证据表明BMAC与CD联合更有效。
与基线相比，使用或不使用BMAC的髓芯减压在功能结局方面均有显著改善。未来高质量的RCT将有助于阐明我们对BMAC与CD联合治疗减轻症状和提高整体功能效果的理解。
