Outcome of Kienböck’s disease in twelve cases: a mid-term follow-up study

Abstract

METHODSA total of 12 patients (9 male and 3 female) with Kienböck's disease were included in the present case series.The mean age of the 12 patients was 28 years. One patient presented in Lichtman stage I, five in Lichtman stage II, five in Lichtman stage IIIa, and one in Lichtman stage IV. Univariate and multivariate analyses of the obtained data were performed to identify any correlations. RESULTSThe mean follow-up time was 62 months, and the mean modified Mayo wrist score improved from the preoperative value of 29.5 to the final value of 89.6. Lichtman stage at presentation showed moderate positive correlation with the duration of symptoms (r = 0.56), and a strong negative correlation with the preoperative and final modified Mayo scores (r = -0.89 and r = -0.77, respectively). The final modified Mayo score showed moderate negative correlation with the duration of the symptoms (r = -0.55). There was a significant difference in the preoperative modified Mayo scores of patients who presented in stage II and those of patients who presented in stage IIIa (p = 0.03). However, the difference in the final modified Mayo scores of the patients in these stages was not significant (p = 0.14). CONCLUSIONLichtman's stage is moderately related to the duration of symptoms, suggesting natural progression of the disease. The final outcomes of stages II and IIIa were the same irrespective of the surgical treatment (radial shortening and/or vascularised bone grafting).

Kienbock Disease, a Tertiary Care Experience from the Developing World

“…It is characterized by lunate sclerosis, cystic changes, fragmentation and articular surface collapse on plain radiograph [3,4]. It occurs most commonly in men aged 20 to 40 years of age.…”

“…Various standard modalities are used to treat this disease, including nonsurgical management, vascularised bone graft (VBG), joint levelling procedures, intercarpal arthrodesis, proximal row carpectomy and total wrist arthrodesis [8,9]. Gupta et al in 2014 presented their experience in 12 patients and found improvement in the functional outcome after treatment [3]. Our study aims to determine the functional and radiological outcome after surgery for Kienbock's disease.…”