18 patients (28 hips) with osteonecrosis of the femoral head (ONFH) were randomized to receive core decompression with or without a concentrated bone marrow injection. The aim of this study was to compare the aforementioned treatments, in order to determine the effects of stem cell augmentation on ONFH. Patients were assessed based on a visual analog scale, the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, and MRI scans over 24 month follow-up. Results indicated significant improvements in VAS and WOMAC scores among both groups, although the group which had a bone marrow injection experienced significantly greater improvements. The group which received the bone marrow concentrate injection displayed improvement in MRI results, whereas patients who underwent core decompression alone exhibited significantly worsened MRI results.