Highlight
– Stem cell therapy (SCT) combined with mechanical support or bone grafting shows potential to improve functional outcomes in avascular necrosis of the femoral head (ONFH).
– Pure SCT alone generally fails to demonstrate statistically significant improvements.
– SCT combined with mechanical support may reduce risk of total hip replacement (THR) and improve Harris Hip Score (HHS).
– Evidence certainty is moderate for delaying THR but low for other outcomes due to methodological variability.