Altered Patterns of Subchondral Bone Mineralization in Kienböck’s Disease

The pattern of subchondral bone density, which is supposed to reflect the long-term distribution of stress, was investigated in both wrist joints of nine healthy young subjects and seven patients suffering from Kienböck’s disease by means of CT osteoabsorptiometry. Two density maxima were found on the distal articular surface of the radius in the healthy subjects, corresponding to the position of the scaphoid and the lunate. Our relative quantitative results showed three different physiological types of stress indicated by the predominantly monocentric density maxima either on the scaphoid or the lunate surface of the radius and the symmetrical distribution of the mineralization. In Kienböck’s disease no type of mineralization predominated. In the progressive stages the lunate density maximum was absent. The overall mineralization was generally less than in controls. Changes in the pattern of mineralization were also found on the contralateral side.

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Subchondral bone mineralization patterns in Kienböck's disease

The Journal Of Hand Surgery ◽

10.1053/jhsu.2001.24976 ◽

2001 ◽

Vol 26 (3) ◽

pp. 561 ◽

Cited By ~ 2

Author(s):

Riccardo Giunta

Keyword(s):

Subchondral Bone ◽

Bone Mineralization ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Kienbock’S Disease

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Scaphotrapeziotrapezoid (STT)-Arthrodesis in Kienböck’s Disease

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2004.03.005 ◽

2004 ◽

Vol 29 (6) ◽

pp. 580-584 ◽

Cited By ~ 41

Author(s):

R. MEIER ◽

M. VAN GRIENSVEN ◽

H. KRIMMER

Keyword(s):

Functional Result ◽

Contralateral Side ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Long Term Effect ◽

Advanced Stages ◽

The Mean ◽

Kienbock’S Disease

This study reviews the results of 59 of 84 patients with severe Kienböck’s disease who were treated with STT fusion. The average follow-up period was 4 (ranges: 2–8) years. The average arc of wrist extension and flexion was 67° (60% of the contralateral side, 81% of pre-operative range) and that of ulnar and radial deviation was 31° (52% of the contralateral side, 56% of pre-operative range). Pre-operative pain values (VAS) were 56 (non-stress) and 87 (stress) and were significantly higher than the postoperative values of 12 (non-stress) and 41 (stress). Grip strength improved from 45 kPa pre-operatively to 52 kPa postoperatively. The mean modified Mayo wrist score was 63 points. The patients reported low disability in the DASH scores, with an average of 28 points. Our data show that STT fusion is a reliable and effective treatment for pain relief and offers a good functional result in advanced stages of Kienböck’s disease. However the long-term effect of this procedure on radioscaphoid and other intercarpal joints is yet to be determined.

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Clinical outcome of combined scaphocapitate fusion and posterior interosseous neurectomy for stage III Kienbock’s disease

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20194810 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1025

Author(s):

Hossam Elden A. Abodonia ◽

Mohammed H. Elbadawy ◽

Ahmed A. Basha

Keyword(s):

Range Of Motion ◽

Grip Strength ◽

Positive Impact ◽

Contralateral Side ◽

Stage Iii ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Flexion Extension ◽

The Mean ◽

Kienbock’S Disease

Background: Treatment of Kienbock’s disease is still controversial. Several authors have described various surgical treatment options for Kienbock’s disease, all of whom reported successful treatment outcomes. The purpose of this study is to explore the clinical results of posterior interosseous neurectomy and scaphocapitate fusion as a treatment option for stage III Kienbock’s disease.Methods: This study evaluated the range of motion, grip and functional results after treatment of ten wrists of stage III Kienbock’s disease. Four males and six females with average age of 26.3 years, seven dominant and three non-dominant wrists were included. Two patients were smokers while six were housewives, three manual workers and a lawyer. The average follow up period was 14.2 months.Results: Four patients revealed excellent, three good and three fair results. The mean modified Mayo score was 81.5. Flexion-extension range was 105.5° representing 74.9% of the contralateral side range. The mean flexion and extension range of operated side was increased, while the flexion increase was nonsignificant. Regarding radial-ulnar deviation, the mean range was 33.5° representing 76.5% of the contralateral side. The mean ulnar and radial deviation was increased, while the radial increase was nonsignificant. The mean grip strength was significantly increased to 90 mmHg representing 93.2% of the contralateral side.Conclusions: Scaphocpitate fusion is a recommended solution for treatment of late stages of Kienbock’s disease with lunate collapse. Longer postoperative time has a positive impact on grip strength and flexion-extension range of motion.

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Proximal Row Carpectomy in Advanced Kienbock’s Disease

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.06.024 ◽

2005 ◽

Vol 30 (6) ◽

pp. 585-587 ◽

Cited By ~ 33

Author(s):

L. DE SMET ◽

PH ROBIJNS ◽

I. DEGREEF

Keyword(s):

Pain Syndrome ◽

Contralateral Side ◽

Dash Score ◽

Proximal Row Carpectomy ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Superficial Wound ◽

The Mean ◽

Kienbock’S Disease

This retrospective study assessed the outcomes of 21 patients (16 male and 5 female, mean age 39 years) with advanced Kienbock’s disease treated by resection of the proximal carpal row. They were clinically reviewed. The mean follow-up was 67 months, with all but two patients having had a follow-up of 2 years. No or mild pain was being experienced by 13 patients, moderate pain by 3 and severe pain by 5. Grip strength increased from 19 kg preoperatively to 26 kg postoperatively (or 65% of the normal contralateral side). There was a slight increase of mobility. The DASH score was 22 points (range 0–78) and the Patient Rated Wrist Score (PRWS) was 30 points (range 0–84). Two patients developed Complex Regional Pain Syndrome which was ongoing at the time of review and one developed a superficial wound infection. Proximal carpal row resection arthroplasty gave satisfactory results in patients with advanced Kienbock’s disease.

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