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DOI: 10.1055/s-0043-1772253
Arthroscopic Lunate Excision for Stage 3 Kienbock's Disease
Funding None.![](https://www.thieme-connect.de/media/jws/EFirst/lookinside/thumbnails/10-1055-s-0043-1772253_2300045-1.jpg)
Abstract
Background The ideal treatment of stage 3 Kienbock's disease is uncertain, with current open procedures conferring the risk of carpal instability, ulnar translocation, and stiffness. We present our technique of arthroscopic lunate excision, and discuss our short- to medium-term results.
Description of Technique Via standard wrist arthroscopic portals, the lunate is excised using a combination of shavers, burrs, and rongeurs. Care is taken to preserve the extreme dorsal and volar cortices of the lunate to prevent carpal instability. A short arm backslab is applied for 2 weeks, after which the patient commences range of motion.
Patients and Methods Consecutive patients undergoing arthroscopic lunate excision at a single center in Paris, France, underwent pre- and postoperative assessment. Parameters assessed include range of motion, as well as patient-reported outcome measures (PROMs).
Results A cohort of 13 patients (7 females and 6 males with a mean age of 27.2 years) underwent arthroscopic lunate excision, and were followed up for a mean of 1.96 years. Significant improvements were noted in flexion, extension, pronation, grip strength, and PROMs.
Conclusions Arthroscopic lunectomy provides significant improvements in clinical and PROMs at short- to medium-term follow-up, and conserves other salvage options in case of failure. Long-term clinical follow-up and further biomechanical studies would be beneficial.
Note
This work was presented at Institute de la Main, Clinique Bizet, 22 bis, Rue Georges Bizet, 75116, Paris, France.
Publication History
Received: 12 April 2023
Accepted: 18 July 2023
Article published online:
11 September 2023
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