Clinical Experience of Surgical Treatment for Kienboeck's Disease.

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We treated 6 cases of Kienböck's disease with revascularization for 2 cases, replacement arthroplasty using bone cored tendon ball for 3 cases and bone graft for 1 case. The age at surgery ranged from 30 to 56 years, with an average of 40 years. The follow-up periods ranged from 6 months to 9.5 years, with an average of 4.5 years. The preoperative stage classification described by Lichtman et al was stage II for 1 case, stage III a for 3 cases, and stage III b for 2 cases.Clinical results according to Lichtman's criteria were evaluated as satisfactory in 3 cases and unsatisfactory in 3 cases. The period before returning to work ranged from 2 months to 6.5 months, with an average of 5 months. Carpal height ratio (CHR) decreased in 3 cases with replacement arthroplasty using bone cored tendon ball. Osteoarthritis appeared in 2 cases with replacement arthroplasty using bone cored tendon ball. MRI suggested existence of normal marrow in cored bone and improvement of viability of lunate bone with revascularization.In conclusion, surgical treatment for Kienböck's disease should be selected after considering the patient's age, occupation, and stage of disease and it may be an effective treatment.
西日本整形・災害外科学会の論文