Regenerative therapies for femoral head necrosis in the past two decades: a systematic review and network meta-analysis

• MSCs and BMAC combined with core decompression significantly reduce ONFH progression and conversion to THA compared to CD alone. • MSCs ranked first and BMAC second in the surface under the cumulative ranking (SUCRA) analysis among six regenerative therapies. • No significant benefit was found for FVBG, PRP, ABG+BMAC, or ABG over CD alone in preventing ONFH progression or THA conversion. • These findings support the use of MSCs and BMAC as adjuncts to core decompression for treating femoral head necrosis.