Addendum: Kienböck Disease: A New Algorithm for the 21st Century

Lichtman, David M.; Pientka, William F.; Bain, Gregory I.

doi:10.1055/s-0037-1604137

Cited by 6 publications

(12 citation statements)

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“…The management of kienbock's disease should consider a several important concepts that determine the outcome of the patient such as patient's age, the lunate revascularization potential, the pathoanotomical aspects of the lunate disease and its secondary effects on the wrist (14). The age at presentations is important since pediatrical (<15 years) and elderly (>70 years) patients has better prognosis and respond very well to non-operative treatments in most cases (18).…”

Section: Discussionmentioning

confidence: 99%

“…For patients, 21 to 69 years, it is important to consider the lunate stage. Thus, if the lunate is intact (Lichtman stage 0, I and II; Schmitt stage A and Bain grade 0), treatment aims to protect the vulnerable lunate, first by non-operative management as short arm cast for at least 3 months (14). For patients who fail non-operative management, lunate unloading procedures are considered, such radial shortening osteotomy (RSO) for patients with negative ulnar variance.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with neutral or positive ulnar variance, a capitate shortening osteotomy should be performed. Lunate decompression (LD) by forage is also an option at this stage (14). In case of the lunate is compromised (Lichtman stage IIIA, Schmitt stage B and Bain grade 1), a reconstruction of the proximal lunate with vascularized medial femoral trochlear graft (MFTG) is indicated (19).…”

Section: Discussionmentioning

confidence: 99%

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20 Years’ Experience in Treating Kienbock’s Disease: About 15 Cases and Review of Literature

Chalouah

Mohamed

Kamal

et al. 2022

ABCMed

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Kienböck’s disease is a rare condition. It affects young adults who are mostly manual workers. Radiology allows diagnosis and classification of the disease using the Lichtman classification which will guide the therapeutic strategy. The aim of the present work is to review the clinical data, recent advances in assessment methods (MRI and arthroscopy) and our therapeutic results compared to the literature. Material and methods: This is a retrospective study of fifteen cases of Kienböck’s disease, collected in the Traumatology-Orthopaedics Department I of the Mohamed V Military Hospital in Rabat, Morocco, over a 20 years period, from 2001 to 2020. This study included 10 men and 5 women, with an average age of 29 years. All of our patients underwent plain radiographs that allowed diagnosis and staging. Only 6 patients benefited from MR imaging and none of them had cartilage arthroscopic assessment. Radial shortening osteotomy were performed for 14 patients and lunate decompression by forage for one patient with good results in 53% and 14% of poor results. Discussion: Comparing the results of our study with those of the literature, we found concordance regarding clinical, radiological and therapeutic methods. However, this study has shown insufficient use of MRI for viability evaluation of the lunate and cartilage arthroscopic assessment, due in first place to their high cost for developing countries as ours. Thus, treatment choices weren’t accurate enough, which explains our 47% poor to fair results. Conclusion: Kienböck’s disease is a rare condition that should be early diagnosed with accurate staging using recent advances in assessment methods which allows proper treatment choices to prevent its evolution toward total destruction of the wrist. However, patient’s desires and needs, surgeon’s experience and capabilities of their facilities precondition the final decision.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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20 Years’ Experience in Treating Kienbock’s Disease: About 15 Cases and Review of Literature

Chalouah

Mohamed

Kamal

et al. 2022

ABCMed

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“…11 y 12). 22,23 Es altamente confiable y reproducible y tiene mayor relevancia clínica porque ayuda a determinar el tratamiento más adecuado.…”

Section: Osteonecrosis Semilunarunclassified

“…Finalmente, los procedimientos de rescate como la carpectomía, fusión del hueso carpiano y la artroplastia total de la muñeca se destinan a pacientes en estadio IV. 23 A pesar que se ofrecen muchos procedimientos quirúrgicos, por el Fig. 10 Paciente de sexo femenino de 60 años de edad con ON de cabeza humeral en estadio IV según la clasificación de Cruess.…”

Section: Osteonecrosis Semilunarunclassified

No dejemos morir al hueso: interiorizándonos con los procesos óseos avasculares

Mena

Mendoza

Galván

et al. 2020

Revista Argentina de Radiología / Argentinian Journal of Radiol

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ResumenEl objetivo de este artículo es realizar una revisión de las localizaciones, causas y hallazgos radiológicos específicos de los procesos avasculares óseos.Se define como isquemia ósea a las alteraciones ocasionadas por déficit de irrigación, llevando a la destrucción del hueso. Existen diferencias entre necrosis isquémica e infarto óseo, en base al sitio óseo de afectación. La etiología traumática es la más frecuente y suele ser unilateral. Los sitios de presentación más frecuentes son: cabeza femoral y humeral, rodilla y semilunar.La resonancia magnética (RM) es considerada la modalidad de imagen más sensible y específica, tanto para el diagnóstico temprano como estadificación y control.El conocimiento de las causas, características radiológicas y sus diferentes fases evitan el diagnóstico erróneo de otras etiologías, como las primarias o infecciosas, facilitando un correcto algoritmo terapéutico.

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Kienböck’s disease: preventing disease progression in early-stage disease

Salvà-Coll

Esplugas

Carreño

et al. 2023

J Hand Surg Eur Vol

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Currently Kienböck’s disease remains an ‘unsolved’ problem in hand surgery. Different factors have been associated with the avascular necrosis of the lunate. Mechanical, vascular and biological factors, alone or in combination, may have an influence in the aetiopathogenesis and determine the progress of the disease and even the results of the treatment. This is especially relevant in the early stages, in which conservative or surgical treatment may modify the natural history of the disease, maintaining the lunate structure and thus preserving the joint surfaces. There are multiple surgical treatments for Kienböck’s disease in the early stages, before lunate collapse; each one is based on one of the possible factors that can cause avascular necrosis of the lunate. The objective is not only to treat symptoms but to prevent progression. This article is a review of the most frequent treatments used in the early stages and a personal view of the authors. Level of evidence: V

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Addendum: Kienböck Disease: A New Algorithm for the 21st Century

Cited by 6 publications

References 0 publications

20 Years’ Experience in Treating Kienbock’s Disease: About 15 Cases and Review of Literature

20 Years’ Experience in Treating Kienbock’s Disease: About 15 Cases and Review of Literature

No dejemos morir al hueso: interiorizándonos con los procesos óseos avasculares

Kienböck’s disease: preventing disease progression in early-stage disease

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