Comparative analysis of the treatment of patients with osteonecrosis of the femoral head: Results of Tunneling with SVF + PRP Therapy and Bone Marrow Aspirate

Aseptic necrosis of the femoral head (ANGBC) is a rapidly progressive disease of the hip joint, often leading to deforming arthrosis, especially in young patients. The frequency of ANGBC varies from 1.2% to 12%. The aim of the study was to evaluate the effectiveness of tunneling with the introduction of SVF+PRP therapy, bone marrow aspirate from the iliac wing and PRP therapy into the necrosis site, followed by conservative and rehabilitative treatment, unloading of the limb in aseptic necrosis of the femoral head. Methods. The study included 153 adult patients who were treated by tunneling with the introduction of SVF+PRP therapy, as well as bone marrow aspirate into the necrotic area, at the CITYMED clinic, Shymkent, Kazakhstan, from 2020 to 2023. Postoperative treatment included conservative therapy and rehabilitation measures with unloading of the affected limb for up to three months. Clinical and radiological outcomes were evaluated, including wound healing, limb length measurement, and joint range of motion assessment. Results. The data obtained showed a significant improvement in clinical and radiological parameters in most patients. A reduction in wound healing time, an improvement in limb length and an increase in the range of motion in the affected joint compared with preoperative indicators were noted. Conclusion. The use of tunneling with the introduction of SVF+PRP therapy, as well as bone marrow aspirate into the necrotic area, demonstrates high effectiveness in the treatment of aseptic necrosis of the femoral head, contributing to the improvement of clinical and functional outcomes. Keywords: aseptic necrosis of the femoral head, tunneling, SVF+PRP therapy, bone marrow aspirate, clinical outcomes.