Aged-onset Kienb�ck's disease

Yoshida, Tomokazu; Tada, Koichi; Yamamoto, Koji; Shibata, Toru; Shimada, Kozo; Kawai, Hideo

doi:10.1007/bf00419936

Cited by 23 publications

(14 citation statements)

References 13 publications

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“…These characteristics were found in our patient. In addition, based on the clinical study, Yoshida et al 8 indicated that osteoporosis is an aetiologic factor of Kienböck's disease. Senile or post-menopausal osteoporosis in our patient might be a risk factor for avascular necrosis of the lunate after repetitive minor trauma through the practice of kendo.…”

Section: Discussionmentioning

confidence: 99%

Elderly Kendo (Japanese Fencing) Player With Kienböck's Disease in One Wrist and Preiser's Disease in the Other Wrist: A Case Report

et al. 2010

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Elderly patients suffering from avascular necrosis of a carpal bone in both wrists are extremely rare. We report a case of an elderly kendo (Japanese fencing) competitor who sustained Preiser's disease in the left hand following the occurrence of Kienböck's disease in the right hand. The current case demonstrates the importance of raising awareness of these diseases as potential sports-related problems in the elderly.

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Section: Discussionmentioning

confidence: 99%

Elderly Kendo (Japanese Fencing) Player With Kienböck's Disease in One Wrist and Preiser's Disease in the Other Wrist: A Case Report

et al. 2010

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“…9 In the elderly patient, Kienböck disease behaves differently in comparison to the pediatric and adult cohorts. [10][11][12][13][14] In Kienböck patients older than 70 years, there is less negative ulnar variance, a higher prevalence in women, who had more advanced radiological changes. 11 At a mean follow-up of 5.6 years, all 15 patients progressed to stage IV disease but had good-to-excellent clinical outcomes without surgery.…”

mentioning

confidence: 99%

Kienböck Disease: A New Algorithm for the 21st Century

2016

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Background It has been over 100 years since the initial description of avascular necrosis of the lunate. Over the last two decades, there has been the introduction of advanced information regarding the etiology, natural history, classification, and treatment options for lunate osteonecrosis. There have been new classifications developed based on advanced imaging, perfusion studies of lunate viability, and arthroscopic assessment of the articular cartilage. Purpose This article brings together a new treatment algorithm, incorporating the traditional osseous classification system (Lichtman) with the perfusion/viability classification (Schmitt) and the articular cartilage classification (Bain). Methods We have developed a new algorithm to manage Kienböck avascular necrosis of the lunate. This new algorithm incorporates the current concepts of the diseased lunate and its effects on the remainder of the wrist. Conclusion For patients with a good prognosis and in the earliest stages, the "intact lunate" is initially protected utilizing nonoperative measures. If this fails, then appropriate lunate unloading procedures should be considered. If the lunate is "compromised" then it can be reconstructed with a medial femoral condyle graft or proximal row carpectomy (PRC). With the further collapse of the lunate, the wrist is then also compromised, with the development of secondary degeneration of the central column articulation. The "compromised wrist" will have functional articulations, which allows motion-preserving procedures to be utilized to maintain a functional wrist. With advanced disease (Kienböck disease advanced collapse), the wrist is not reconstructable, so only a salvage procedure can be performed. Other than these objective pathoanatomical factors, the final decision must accommodate the various patient factors (e.g., age, general health, lifestyle, financial constraints, and future demands on the wrist) and surgeon factors (skill set, equipment, and work environment).

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“…Three of the 4 reported cases in patients over the age of 65 are women, with the oldest being 75 years old. [5][6][7][8] Therefore osteoporosis, seen commonly in elderly women, may be a contributing factor to the development of Kienböck's disease whereas repetitive microtrauma may account for the majority of cases in the younger male population. …”

Section: Discussionmentioning

confidence: 97%

“…Three of the 4 reported cases of Kienböck's disease in patients age 65 and older are women, with the oldest being 75 years of age. [5][6][7][8] The following case shows an additional presentation of Kienböck's disease in a woman over 65 years old who had successful PRC for this condition.…”

mentioning

confidence: 93%