Title : Efficacy of Stromal Vascular Fraction (SVF) in the management of Avascular Necrosis (AN) of the femoral head: A two-year follow-up study
Abstract:
Background: Avascular Necrosis (AN) of the femoral head is a debilitating condition that often leads to joint collapse and total hip replacement in young patients. Stromal vascular fraction (SVF), derived from adipose tissue, is a promising regenerative therapy due to its rich content of mesenchymal stem cells and growth factors. This study evaluates the safety and efficacy of intraosseous SVF injection in patients with early-stage AVN.
Methods: A prospective interventional study was conducted on 30 patients (36 hips) with Ficat-Arlet Stage I or II AVN of the femoral head. SVF was harvested via liposuction and processed using enzymatic digestion. Under fluoroscopic guidance, SVF was injected into the necrotic area of the femoral head. Patients were followed for 24 months with serial clinical and radiological assessments. Outcome measures included Visual Analog Scale (VAS) for pain, Harris Hip Score (HHS), and MRI-based evaluation of lesion size and progression.
Results: At 24-month follow-up, 83.3% of treated hips showed clinical improvement with a mean HHS increase from 62.4 ± 6.3 to 87.1 ± 5.8 (p < 0.001). VAS scores decreased significantly from 7.1 ± 1.1 to 2.3 ± 0.9 (p < 0.001). MRI demonstrated stabilization or reduction in lesion size in 75% of cases. No major complications or adverse events related to SVF harvesting or injection were observed.
Conclusion: Intraosseous injection of autologous SVF appears to be a safe and effective minimally invasive option for early-stage AVN of the femoral head. It may delay or prevent the need for joint replacement in selected patients. Further randomized controlled trials are recommended to validate these findings.
Keywords: Avascular necrosis, femoral head, stromal vascular fraction, Orthobiology, stem cell therapy, regenerative orthopedics, hip preservation.
