Chinese expert consensus on the clinical application of stromal vascular fraction combined with bone marrow flushing for osteonecrosis of the femoral head.

Osteonecrosis of the femoral head (ONFH) is a common orthopedic disease that leads to severe dysfunction of the hip joint in young and middle-aged patients. Its core pathological mechanism lies in the interruption of blood supply to the femoral head and an imbalance in bone repair capacity. Traditional hip-preserving treatment methods face many limitations in promoting effective repair of the necrotic area. With the rapid development of regenerative medicine, stromal vascular fraction (SVF) therapy, due to its rich content of various repair cells and growth factors, provides a highly promising new strategy for promoting angiogenesis and bone tissue regeneration in the necrotic area. Bone marrow flushing, as a key auxiliary means to optimize the local repair microenvironment, can further enhance the therapeutic effect when combined with SVF. This expert consensus aims to systematically review the current evidence-based medical evidence and clinical practice experience of SVF combined with bone marrow flushing in the treatment of ONFH, and to clarify the core norms and operational standards for its clinical application. The article will focus on in-depth elaboration of the indications and contraindications for SVF therapy, the standardized preparation and quality control system of cell preparations, key technical points of clinical minimally invasive surgical operations (including bone marrow flushing standards), multi-dimensional efficacy evaluation methods, and prevention and management strategies for potential complications. It is intended to provide clinicians with a set of standardized and scientific practical guidelines, ultimately promoting the safe, standardized, and effective application of SVF combined with bone marrow flushing technology in the field of ONFH treatment.