Evidence mapPaperPMID 42100192Full record

SynthesisFrontiers in endocrinology2026

Efficacy of autologous stem cell at different doses combined with core decompression in the treatment of osteonecrosis of the femoral head: a systematic review and network meta-analysis.

Mingjie Wei, Libo Yuan, Guocheng Feng, Baochuang Qi, Xiangwen Shi, Yongqing Xu

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mingjie Wei *Kunming Medical University, Kunming, Yunnan, China.
Libo Yuan *Kunming Medical University, Kunming, Yunnan, China.
Guocheng FengDepartment of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of PLA, Kunming, Yunnan, China.
Baochuang QiDepartment of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of PLA, Kunming, Yunnan, China.
Xiangwen ShiDepartment of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of PLA, Kunming, Yunnan, China.
Yongqing XuDepartment of Orthopedic Surgery, 920th Hospital of Joint Logistics Support Force of PLA, Kunming, Yunnan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To compare autologous stem cell (SC) at different doses combined with core decompression (CD) versus CD alone for osteonecrosis of the femoral head (ONFH), using conversion to total hip arthroplasty (THA) as the primary outcome. Methods: PubMed, Embase, Cochrane Library, Web of Science, and CNKI were systematically searched (from inception to July 2025) to identify studies comparing different SC dosages (low dose: <1×10^7; medium dose: 1×10^7-10×10^8; high dose: >1×10^8). Conventional meta-analyses were performed using Review Manager 5.3, while network meta-analyses (NMA) were conducted with Stata 16.0. Treatment efficacy was ranked using SUCRA curves. Sensitivity analyses and funnel plots were applied to assess the robustness of the findings and potential publication bias. Results: Eighteen studies involving 1,192 patients were included. Compared with CD alone, evidence from conventional meta-analysis and network meta-analysis suggested that high-dose autologous stem cell therapy (>1×10^8 cells) combined with CD was associated with a lower risk of hip failure (conversion to THA) (OR = 0.24, 95% CI: 0.12 to 0.44). The high-dose group was also associated with a lower rate of femoral head collapse (OR = 0.24, 95% CI: 0.08 to 0.74) and lower VAS score (SMD = -1.93, 95% CI: -3.64 to -0.23). However, no statistically significant advantage of the high-dose group over the low- or medium-dose groups was observed, and no clear differences in incidence of adverse events (AEs) were detected across dose categories. Conclusions: Preliminary evidence suggests that, compared with CD alone, high-dose autologous stem cell therapy (>1×10^8 cells) combined with CD is associated with a lower risk of hip failure and a lower femoral head collapse rate, with additional improvements in pain in some comparisons. However, the certainty of evidence is limited by heterogeneity in study design, follow-up, and cell dose reporting. Future studies should emphasize standardized cell processing and intervention dosing to validate the dose-response relationship and establish the optimal clinical dosage. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record, identfier CRD420251154025.

Indexed as

Decompression, SurgicalFemur Head NecrosisStem Cell TransplantationCombined Modality TherapyHumansTransplantation, AutologousTreatment Outcomecore decompressiondosesnetwork meta-analysisosteonecrosis of the femoral headstem cells

Identifiers

PMID42100192
PMCPMC13143691

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.