Update on the Use of Arthroscopy in Kienböck's Disease Management

Abstract

Kienböck's disease is a clinical-radiological condition that can permanently affect wrist functionality and the patient's quality of life. Proper, pertinent diagnosis and treatment are required to avoid salvage procedures. Arthroscopic techniques have emerged as an important tool for the treatment of certain stages of the disease.

We present a review of the literature and propose a treatment algorithm according to the stage of the disease, including arthroscopic techniques. We detail the surgical technique of arthroscopic scaphocapitate arthrodesis, and the functional outcomes obtained by our group.

Keywords

Kienböck's disease - lunate avascular necrosis - wrist arthroscopy - scaphocapitate arthrodesis - partial wrist fusion.

Publication History

Received: 05 October 2020

Accepted: 15 October 2020

Article published online:
24 November 2020

• References

• 1 Bain GI, MacLean SB, Yeo CJ, Perilli E, Lichtman DM. The Etiology and Pathogenesis of Kienböck Disease. J Wrist Surg 2016; 5 (04) 248-254
• 2 Leblebicioğlu G, Doral MN. Atay A öA, Tetik O, Whipple TL Open treatment ofstageIIIKienböck's disease with lunate revascularization compared with arthroscopic treatment without revascularization. Arthroscopy 2003; 19 (02) 117-130
• 3 Lichtman DM, Pientka II WF, Bain GI. Kienböck Disease: A New Algorithm for the 21st Century. J Wrist Surg 2017; 6 (01) 2-10
• 4 Fontaine C. Kienböck's disease. Chir Main 2015; 34 (01) 4-17
• 5 Ertem K, Görmeli G, Karakaplan M, Aslantürk O, Karakoç Y. Arthroscopic limited intercarpal fusion without bone graft in patients with Kienböck's disease. Eklem Hastalik Cerrahisi 2016; 27 (03) 132-137
• 6 Iorio ML, Kennedy CD, Huang JI. Limited intercarpal fusion as a salvage procedure for advanced Kienbock disease. Hand (N Y) 2015; 10 (03) 472-476
• 7 Bain GI, MacLean SB, Tse WL, Ho PC, Lichtman DM. Kienböck Disease and Arthroscopy: Assessment, Classification, and Treatment. J Wrist Surg 2016; 5 (04) 255-260
• 8 Ho PC. Arthroscopic partial wrist fusion. Tech Hand Up Extrem Surg 2008; 12 (04) 242-265
• 9 Geutjens GG. Kienböck's disease in an elderly patient. J Hand Surg Am 1995; 20 (01) 42-43
• 10 Beckenbaugh RD, Shives TC, Dobyns JH, Linscheid RL. Kienböck's disease: the natural history of Kienböck's disease and consideration of lunate fractures. Clin Orthop Relat Res 1980; (149) 98-106
• 11 Bain GI, Begg M. Arthroscopic assessment and classification of Kienbock's disease. Tech Hand Up Extrem Surg 2006; 10 (01) 8-13
• 12 Lichtman DM, Degnan GG. Staging and its use in the determination of treatment modalities for Kienböck's disease. Hand Clin 1993; 9 (03) 409-416
• 13 Gelberman RH, Bauman TD, Menon J, Akeson WH. The vascularity of the lunate bone and Kienböck's disease. J Hand Surg Am 1980; 5 (03) 272-278
• 14 Stahl F. On lunatomalacia (Kienböck's disease): clinical and roentgenological study, especially on its pathogenesis and late results of immobilization treatment. Acta Chir Scand 1947; 95 (Suppl. 126) 1-133
• 15 Tatebe M, Koh S, Hirata H. Long-Term Outcomes of Radial Osteotomy for the Treatment of Kienböck Disease. J Wrist Surg 2016; 5 (02) 92-97
• 16 Illarramendi AA, De Carli P. Radius decompression for treatment of kienböck disease. Tech Hand Up Extrem Surg 2003; 7 (03) 110-113
• 17 De Carli P, Zaidenberg EE, Alfie V, Donndorff A, Boretto JG, Gallucci GL. Radius Core Decompression for Kienböck Disease Stage IIIA: Outcomes at 13 Years Follow-Up. J Hand Surg Am 2017; 42 (09) 752.e1-752.e6
• 18 Moran SL, Cooney WP, Berger RA, Bishop AT, Shin AY. The use of the 4 + 5 extensor compartmental vascularized bone graft for the treatment of Kienböck's disease. J Hand Surg Am 2005; 30 (01) 50-58
• 19 Sutro CJ. Treatment of nonunion of the carpal navicular bone. Surgery 1946; 20: 536-540