Kienböck's disease—Update on silicone replacement arthroplasty

Lichtman, David M.; Alexander, A H; Mack, Gregory R.; Gunther, Stephen F.

doi:10.1016/s0363-5023(82)80142-1

Cited by 188 publications

(92 citation statements)

References 6 publications

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“…On the contrary, Lichtman et al (1977) emphasized silicone implant arthroplasty in the early stages of the disease. The technical details of arthroplasty are important: too large a prosthesis will be forced out of position by pressure from the capitate; too small an implant may slip out of position; careful preservation of the volar wrist ligaments and tight closure of the dorsal capsule are necessary.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Silicone implant arthroplasty in Kienböck's disease

Viljakka

Vastamäki

Solonen

et al. 1987

Acta Orthopaedica Scandinavica

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Section: Resultsmentioning

confidence: 99%

“…Roca et al (1976), Lichtman et al (1977), Bertini et al (1982), and Ramakrishna et al (1982) have reported acceptable results in 59 cases treated by this technique. We report our experience in 55 patients with advanced malacia of the lunate treated by replacement with a Swanson implant.…”

Section: Silicone Implant Arthroplasty In Kienbock's Diseasementioning

confidence: 92%

Silicone implant arthroplasty in Kienböck's disease

Viljakka

Vastamäki

Solonen

et al. 1987

Acta Orthopaedica Scandinavica

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“…In addition, radiographic evidence of arthritis was assessed according to the grading scale established by Knirk and Jupiter [15]. Avascular necrosis of the lunate was graded using plain radiographs and according to the classification of Lichtman et al [18].…”

Section: Methodsmentioning

confidence: 99%

Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

Capo¹,

Corti

Shamian

et al. 2012

Hand (New York, N,Y.)

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Background The aims of this study were to evaluate the associated injuries occurring with acute perilunate instability and to assess the clinical and radiographic outcomes of perilunate dislocations and fracture-dislocations treated with a combined dorsal and volar approach. Methods A total of 45 patients (46 wrist injuries) with perilunate dislocations and fracture-dislocations were prospectively evaluated. The size of the mid-carpal ligament tear, the location of the scapholunate ligament tear, and the presence of osteochondral fragments and of the dorsal radiocarpal ligament avulsions were recorded at injury. Final clinical and radiographic outcomes were evaluated in 25 cases (25 wrists) with a minimum of 6 months of follow-up. Results Intraoperative examination of the 46 cases with operative treatment showed the volar carpal ligament tear to be present 100 % of the time and to be an average length of 3.4 cm. Complete avulsion of the dorsal extrinsic radiocarpal ligaments was found in 65.2 % of cases. The scapholunate ligament was torn in 35 cases. Osteochondral fragments were found either volarly or dorsally in 74 % of the cases. The average flexion-extension arc was 82°, forearm rotation was 155°, and grip strength averaged 59 % of the uninjured hand. The average final scapholunate angle was 55°and the scapholunate gap was 2.2 mm. Conclusion Treatment of perilunate fracture-dislocations with a combined volar and dorsal approach results in reasonable and functional clinical results. The incidence of associated injuries with these carpal dislocations is high. Although the perilunate fracture-dislocations have a slightly better radiologic alignment than the dislocation group, the clinical outcome is similar.

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“…It is generally accepted that as the disease progresses, initial sclerosis of the lunate eventually leads to collapse and osteoarthritis [1,4]. The Lichtman classification system is commonly used for staging [11]. Treatment of Kienböck's disease can vary from conservative to complex surgical interventions, including joint leveling procedures [20] by radial shortening [22] or ulnar lengthening [19], intercarpal arthrodesis [7,14,16,21], proximal row carpectomy [12], and vascularized bone grafts [9].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes for Kienböck's Disease

Martin

Squire

2012

Hand (New York, N,Y.)

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Background The precise etiology of Kienböck's disease is unclear. Controversy exists regarding the appropriate treatment modality. The present study sought to investigate and compare surgical and nonsurgical treatment outcomes of patients suffering from Kienböck's disease in the province of Newfoundland and Labrador (NL), Canada. Methods The present study was a retrospective analysis of 66 patients. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Student's t test was used to assess differences in outcomes between treatment groups. One-way ANOVA was used to assess differences in primary outcome in time since first assessed in an effort to examine progression over time. Pearson correlation was used to assess for correlation between primary outcome and age at diagnosis. Results The average age was 38.6± 11.4 (18-70) years; Four patients were excluded due to inaccessible imaging. Of the remaining patients, 44 were treated conservatively, while 18 were treated surgically. The DASH scores for the surgical group were 23.7±24.5 (0.9-82.8) and nonsurgical group were 20.0±20.1 (1.7-81). As expected, the surgical group was mainly comprised of late-stage Kienböck's. When both groups were compared, there was no significant difference in the DASH scores. There were no difference in DASH scores within groups according to time since first diagnosed (<5 years; between 5 and 10 years; and >10 years). A positive correlation was found between age at diagnosis and DASH score (r00.42, p00.007), despite treatment modality. This finding remained significant after accounting for confounding factors (p00.029). Conclusion The DASH score for the surgical group was 23.7±24.5 (0.9-82.8) and nonsurgical group was 20.0± 20.1 (1.7-81). No significant difference in DASH scores was found between surgically and nonsurgically treated patients. A positive association was found between the age at diagnosis of Kienböck's and DASH score, which suggests that patients diagnosed and treated later in life tend not to do as well.

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Kienböck's disease—Update on silicone replacement arthroplasty

Cited by 188 publications

References 6 publications

Silicone implant arthroplasty in Kienböck's disease

Silicone implant arthroplasty in Kienböck's disease

Treatment of Dorsal Perilunate Dislocations and Fracture–Dislocations Using a Standardized Protocol

Long-Term Outcomes for Kienböck's Disease

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