Vitallium Replacement of Lunate in Kienbock's Disease

Lippman, Eli M.; McDERMOTT, Leo J.

doi:10.1093/milmed/105.6.482

Cited by 12 publications

(5 citation statements)

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“…To prevent carpal collapse, surgeons began experimental study on replacement arthroplasty. Several methods have been advocated using vitallium (Lippman and McDermott, 1949), acrylic (Agerholm and Goodfellow, 1963), silicone (Swanson, 1970) and coiled tendon (Ueba et al, 1972).…”

Section: Discussionmentioning

confidence: 99%

A Stress Distribution Analysis of a Ceramic Lunate Replacement for Kienböck’s Disease

Oda

Hashizume

Miyake

et al. 2000

Journal of Hand Surgery

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To determine the usefulness of a ceramic lunate replacement for the wrist joint as a possible treatment for Kienböck's disease, stress distribution of five wrist joint models (a normal wrist, one with the lunate bone removed, one with a coiled tendon replacement, one with a coiled tendon replacement with a ceramic core, and one with a ceramic lunate replacement coated with sheets of tendon) were analysed by the finite element method. The results of finite element method analyses were compared with those of pressure distribution analyses on the wrist joint using pressure-sensitive film and measurement of pressure on the radio-lunate joint with a tactile sensor. Both the coiled tendon model and ceramic core model were unable to resist applied force. Stress and pressure were well-distributed in the wrist joint of the ceramic lunate implant model. These results indicate that the ceramic lunate implant could be expected to prevent carpal collapse.

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Section: Discussionmentioning

confidence: 99%

A Stress Distribution Analysis of a Ceramic Lunate Replacement for Kienböck’s Disease

Oda

Hashizume

Miyake

et al. 2000

Journal of Hand Surgery

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“…In case of a completely necrotic lunate bone, revascularization procedures are unlikely to be the optimal treatments, whereas salvage options such as proximal row carpectomy and total wrist fusion may lead to degenerative arthritis resulting from the abnormal loading at the radiocarpal or midcarpal articulation, and are typically reserved for older patients with lower functional demands 5,14 . The techniques for lunate excision and interposition have evolved over time since starting with vitallium prostheses as described by Lippman in 1949 9 , and followed by several alternatives such as silastic and pyrocarbon prostheses. Recently, interposition of tendon-ball implants or fascia, and autografts, such as pedicled pisiform, have also had their advocates 21,22 .…”

Section: Kd Treatmentmentioning

confidence: 99%

“…These happen even in studies detailing techniques that aim to revascularize the lunate or help it regain its original shape 7 . Several studies reported lunate replacement for advanced KD, such as vitallium, acrylic materials and pyrocarbon lunate arthroplasty [8][9][10] . However, these techniques have not been widely applied because of the incongruity and inherent instability of the prostheses 5 .…”

Section: Introductionmentioning

confidence: 99%

Varisized 3D‐Printed Lunate for Kienböck's Disease in Different Stages: Preliminary Results

Liu

Shi

et al. 2020

Orthopaedic Surgery

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Objective: To evaluate the feasibility of arthroplasty with varisized three-dimensional(3D) printing lunate prosthesis for the treatment of advanced Kienböck's disease (KD).Methods: From 2016 November to 2018 September, a retrospective study was performed for the patients of KD in our hospital. Five patients (two males, three females) were included in this study. The mean age of the patients at the time of surgery was 51.6 years (range, 37-64 years). Varisized prosthesis identical to the live model in a ratio of 1:0.85, 1:1, and 1:1.1 were fabricated by 3D printing. All patients (one in Lichtman IIIA stage, two in Lichtman IIIB stage, one in Lichtman IIIC stage, and one in Lichtman IV stage) were treated with lunate excision and 3D printing prosthetic arthroplasty. Visual analog scale score (VAS), the active movement of wrist (extension, flexion) and strength were assessed preoperatively and postoperatively. The Mayo Modified Wrist Score (MMWS), Disabilities of the Arm, Shoulder and Hand (DASH) Score, and patient's satisfaction were evaluated during the follow-up.Results: Prosthesis identical to the live model in a ratio of 1:0.85 or 1:1 were chosen for arthroplasty. The mean operation time (range, 45 to 56 min) was 51.8 AE 4.44 min. Follow-up time ranged from 11 months to 33 months with the mean value of 19.4 months. The mean extension range of the wrist significantly increased from preoperative 44 AE 9.6 to postoperative 60 AE 3.5 (P < 0.05). The mean flexion range of the wrist significantly increased from preoperative 40 AE 10.6 to postoperative 51 AE 6.5 (P < 0.05). The active movement of wrist and strength were improved significantly in all patients. VAS was significantly reduced from 7.3 preoperatively to 0.2 at the follow-up visit (P < 0.05). The mean DASH score was 10 (range, 7.2-14.2), and the mean MMWS was 79 (range, 70-90). There were no incision infection. All patients were satisfied with the treatment.Conclusions: For patients suffering advanced Kienböck's disease, lunate excision followed by 3D printing prosthetic arthroplasty can reconstruct the anatomical structure of the carpal tunnel, alleviate pain, and improve wrist movement.

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“…76,78) There is a long history for lunate replacement, starting with vitallium prostheses as described by Lippman in 1949, 78) and also acrylic materials. 79) Swanson then popularized silastic lunate arthroplasty.…”

Section: Replacement Proceduresmentioning

confidence: 99%

Kienböck Disease: Recent Advances in the Basic Science, Assessment and Treatment

2015

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Kienböck disease is a disorder of impaired lunate vascularity which ultimately has the potential to lead to marked degeneration of the wrist and impaired wrist function. The aetiology of the avascular necrosis is uncertain, but theories relate to ulnar variance, variability in lunate vascularity and intraosseous pressures. Clinical symptoms can be subtle and variable, requiring a high index of suspicion for the diagnosis. The Lichtmann classification has historically been used to guide management. We present a review of Kienböck disease, with a focus on the recent advances in assessment and treatment. Based on our understanding thus far of the pathoanatomy of Kienböck's disease, we are proposing a pathological staging system founded on the vascularity, osseous and chondral health of the lunate. We also propose an articular-based approach to treatment, with an arthroscopic grading system to guide management.

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Vitallium Replacement of Lunate in Kienbock's Disease

Cited by 12 publications

References 0 publications

A Stress Distribution Analysis of a Ceramic Lunate Replacement for Kienböck’s Disease

A Stress Distribution Analysis of a Ceramic Lunate Replacement for Kienböck’s Disease

Varisized 3D‐Printed Lunate for Kienböck's Disease in Different Stages: Preliminary Results

Kienböck Disease: Recent Advances in the Basic Science, Assessment and Treatment

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