CLINICAL OUTCOMES OF EXCISION ARTHROPLASTY FOR KIENBOCK'S DISEASE

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 277-282 ◽  
Author(s):  
Tomoya Matsuhashi ◽  
Norimasa Iwasaki ◽  
Hiroyuki Kato ◽  
Michio Minami ◽  
Akio Minami
Keyword(s):  
Clinical Score ◽  
Clinical Results ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Radiocarpal Joint ◽  
The Mean ◽  
Excision Arthroplasty ◽  
Carpal Height ◽  
Kienbock’S Disease

We have carried out a replacement of the lunate in 12 patients with advanced Kienböck's disease, with excision of the lunate and insertion of an iliac bone flap wrapped into palmaris longus. The aims of this study were to determine the effect of this procedure for advanced Kienböck's disease. At a mean follow-up period of 45.3 months, the mean clinical score was excellent in all cases. Radiographically, progression of osteoarthritis (OA) in the radiocarpal joint was found in two patients. At follow-up, the X-ray findings indicated a reduced of osseous core in four patients. On the other hand, carpal height ratio showed no significant change at follow-up. Excision arthroplasty using a tendon ball with osseous core for advanced Kienböck's disease leads to OA progression in some cases. However, clinical results were excellent in all cases. Therefore, this current study provides effective therapeutic procedure for advanced Kienböck's disease.

Long-term clinical results and MRI changes after tendon ball arthroplasty for advanced Kienböck’s disease

2013 ◽  
Vol 38 (5) ◽  
pp. 508-514 ◽  
Author(s):  
M. Mariconda ◽  
E. Soscia ◽  
C. Sirignano ◽  
F. Smeraglia ◽  
A. Soldati ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Cartilage Damage ◽  
Clinical Results ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Mri Changes ◽  
Carpal Height ◽  
Kienbock’S Disease

The purpose of this study was to assess the long-term clinical results and morphological changes after tendon ball arthroplasty for advanced Kienböck’s disease. Twenty-six patients were reviewed, with a mean follow-up interval of 125 months (range 50–226). At follow-up, mean score on the Disabilities of the Arm, Shoulder, and Hand questionnaire was 7.7 and mean visual analogue scale score for pain was 1. Mean carpal height ratio was significantly reduced with respect to the pre-operative value. On magnetic resonance imaging scans, cartilage damage, synovitis, and erosive or oedematous changes in the bones were detected in most patients. Calcification in the defect filled by the tendon ball was seen in all patients. Narrowing of the radioscaphoid joint and the presence of intercarpal synovitis were negatively associated with clinical outcome. Tendon ball arthroplasty in advanced Kienböck’s disease results in long-term satisfactory clinical outcomes, despite widespread changes in the bones and joints within the wrist.

Arthroscopic Debridement and Arthrolysis for the Treatment of Advanced Kienböck's Disease: 18-Month and 5-Year Postoperative Results

2021 ◽  
Author(s):  
Omer Ayik ◽  
Mehmet Demirel ◽  
Necmettin Turgut ◽  
Okyar Altas ◽  
Hayati Durmaz
Keyword(s):  
Grip Strength ◽  
Dash Score ◽  
Arthroscopic Debridement ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Hand Grip ◽  
Case Series Study ◽  
The Mean ◽  
Kienbock’S Disease

Abstract Background Salvage procedures, such as proximal row carpectomy, limited or total wrist arthrodesis, and wrist replacement, are generally preferred to treat advanced Kienböck's disease. However, these procedures are particularly aggressive and may have unpredictable results and potentially significant complications. Questions/Purpose This study aimed to present the short- to mid-term clinical and functional results of arthroscopic debridement and arthrolysis in the management of advanced Kienböck's disease. Patients and Methods Fifteen patients in whom Lichtman Stages IIIA to IIIC or IV Kienböck's disease was diagnosed and treated by arthroscopic wrist debridement and arthrolysis were included in this retrospective study. The mean age was 30 years (range: 21–45). The mean follow-up period duration was 36 months (range: 18–60). The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), wrist range of motion (ROM), and grip strength were measured preoperatively and then again at the final follow-up visit. Results The mean DASH and VAS scores improved from 41 (range: 31–52) and 7.1 (range: 6–8) preoperatively to 13 (range: 8–21) and 2 (range: 0–3; p < 0.001) at the final follow-up visit, respectively. The mean wrist flexion and extension values increased from 32 (range: 20–60 degrees) and 56 degrees (range: 30–70 degrees; p = 0.009) preoperatively to 34 (range: 10–65 degrees; p = 0.218) and 57 degrees (range: 30–70 degrees; p = 0.296) at the final follow-up appointment, respectively, although these findings were statistically insignificant. The mean strength of the hand grip increased from 22.7 (range: 9–33) to 23.3 (range: 10–34; p = 0.372). Conclusion Arthroscopic debridement and arthrolysis may improve wrist function and quality of life due to the preserved ROM and hand grip strength after short- to mid-term follow-up periods despite the radiographic progression of Kienböck's disease. Level of Evidence This is a Level IV, retrospective case series study.

Scaphotrapeziotrapezoid (STT)-Arthrodesis in Kienböck’s Disease

2004 ◽  
Vol 29 (6) ◽  
pp. 580-584 ◽  
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.

Kienböck’s Disease — Late Results by Non-Surgical Treatment

1986 ◽  
Vol 11 (3) ◽  
pp. 422-425
Author(s):  
S. S. KRISTENSEN ◽  
E. THOMASSEN ◽  
F. CHRISTENSEN
Keyword(s):  
Treated Group ◽  
Late Results ◽  
X Rays ◽  
Efficient Treatment ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Surgical Methods ◽  
Radiocarpal Joint ◽  
Kienbock’S Disease

Two groups of patients with Kienböck’s disease were followed. Twenty-three wrists had been immobilised with plaster and twenty-six had no treatment. At follow up there was a marked improvement in both groups. Eighty-three percent of the wrists in the new treated group were pain free, or reported pain only on heavy work, and in the nontreated group this was valid for 77%. Examining X-rays at follow up we did not find a single wrist in which the lunate was normal or less deformed than at the time of diagnosis. In all forty-nine wrists the lunate was deformed and in 67% osteoarthrosis in the radiocarpal joint was evident. It is concluded, that Kienböck’s disease has a naturally benign course, the remaining symptoms at follow-up might be caused by osteoarthrosis and nothing seems to be gained by rigorous immobilisation. If pain persists efficient treatment must be based on surgical methods.

Proximal Row Carpectomy in Advanced Kienbock’s Disease

2005 ◽  
Vol 30 (6) ◽  
pp. 585-587 ◽  
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.

Scapho-Trapezio-Trapezoid Arthrodesis in the Treatment of Kienböck’s Disease

1992 ◽  
Vol 17 (1) ◽  
pp. 5-11 ◽  
Author(s):  
P. VOCHE ◽  
C. BOUR ◽  
M. MERLE
Keyword(s):  
Grip Strength ◽  
Clinical Results ◽  
Prosthetic Replacement ◽  
Radiographic Assessment ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
Carpal Height ◽  
Kienbock’S Disease

Sixteen scapho-trapezio-trapezoid arthrodeses were performed for Kienböck’s disease. In ten cases, a prosthetic replacement of the lunate was inserted at the same time. Clinical results were good with regard to pain and fair with regard to grip strength which was improved by an average of 32%. In contrast, the arc of flexion-extension was 38% less than on the unoperated side. Long-term radiographic assessment showed the efficacy of the procedure in maintaining carpal height. Biomechanical observations and a review of poor results showed the limits of the method and the importance of correct positioning of the scaphoid. We concluded that triscaphe arthrodesis was a useful procedure for the treatment of Kienböck’s disease in Decoulx’s stage 3.

scholarly journals Extensor carpi radialis longus tendon ball interposition arthroplasty for treatment of late-stage Kienböck’s disease: Short-term results of a novel technique

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880251
Author(s):  
Okan Aslantürk ◽  
Kadir Ertem ◽  
Emre Ergen ◽  
Muhammed Köroğlu
Keyword(s):  
Late Stage ◽  
Visual Analog Scale Score ◽  
Height Ratio ◽  
Short Term ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Extensor Carpi Radialis ◽  
Carpal Height ◽  
Kienbock’S Disease

Purpose: The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienböck’s disease. Methods: We retrospectively reviewed data of 19 patients suffering from Kienböck’s treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients’ clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score. Radiological examination was performed to assess carpal height ratio and progression of arthritis. Results: The median follow-up was 30 months (range, 12–36 months). At final follow-up, ROM of operated wrist was 71% of the nonoperated side. Thirteen (86.6%) patients were pain free. Carpal height ratio was statistically significantly reduced compared with preoperative values. All patients declared their satisfaction with the results due to their preoperative status. Conclusions: ECRL tendon ball arthroplasty is a new and good option for treatment of late-stage Kienböck’s disease with low complication rate.

scholarly journals Descompresión ósea metafisaria del radio distal para estadios tempranos de la enfermedad de Kienböck. Seguimiento mínimo de 10 años. [Metaphyseal bone decompression of distal radius for early stages of Kienböck's disease. Minimum follow-up of 10 years.]

10.15417/757 ◽  
2018 ◽  
Vol 83 (1) ◽  
pp. 25
Author(s):  
Ezequiel Ernesto Zaidenberg ◽  
Pablo De Carli ◽  
Jorge Guillermo Boretto ◽  
Agustin Donndorff ◽  
Veronica Alfie ◽  
...  
Keyword(s):  
Distal Radius ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Early Stages ◽  
Flexion Extension ◽  
Metaphyseal Bone ◽  
Kienbock’S Disease

<p><strong>Introducción</strong></p><p><strong></strong>El objetivo de este trabajo es analizar los resultados clínicos y radiológicos a largo plazo de una serie de pacientes con enfermedad de Kienböck en estadios II y IIIA  de la clasificación de Lichtman, tratados mediante descompresión metafisaria del radio distal.<strong> </strong></p><p><strong>Materiales y Métodos</strong></p><p><strong></strong>Este estudio retrospectivo y descriptivo incluyó a 23 pacientes con enfermedad de Kienböck (estadios II y IIIA de Lichtman) tratados mediante descompresión metafisaria del radio distal con al menos 10 años de seguimiento. Al final del seguimiento, los pacientes fueron evaluados para el rango de movimiento de muñeca, fuerza de puño, escala de Mayo modificada y el dolor, según la escala visual analógica (EVA). Se valoró radiográficamente según la clasificación de Lichtman y el índice de altura carpiana (IAC).</p><p><strong>Resultados</strong></p><p><strong></strong>El seguimiento promedio fue de 14 años (rango 10-19). Nueve eran mujeres y catorce varones. Quince fueron estadio IIIA y ocho estadio II.<strong> </strong>Basado en la escala de Mayo, los resultados fueron excelentes en 9 pacientes, buenos en 11 pacientes, moderados en 2 y pobres en un paciente. La EVA preoperatoria fue 7 (rango 6-10) y fue 1,1 (rango 0-6) en el seguimiento final. El arco de flexión/extensión promedio fue del 78% y la fuerza de puño del 81%. Según la clasificación de Lichtman se produjo progresión en 4 pacientes mientras que los otros 19 pacientes permanecieron en la misma etapa que en el preoperatorio.<strong> </strong></p><p><strong>Conclusión</strong></p><p><strong></strong>La descompresión metafisaria del radio distal demostró resultados favorables a largo plazo para los estadios II y IIIA de la enfermedad de Kienböck.</p>

Sign in / Sign up

Export Citation Format

Share Document