
This study compares various surgical treatments for osteonecrosis of the femoral head (ONFH) through a Bayesian network meta-analysis of 18 randomized controlled trials. Autologous bone grafting (ABG), free fibula grafting (FFG), vascularized bone grafting (VBG), ABG combined with bone marrow aspirate concentrate (ABG + BMAC), and biomaterial grafting with VBG (BMG + VBG) were found to delay ONFH progression compared to core decompression (CD). ABG + BMAC demonstrated the best results. While these methods were effective, no significant differences in preventing total hip arthroplasty were observed.
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