Kienböck’s Disease: Diagnosis and Treatment

Allan, Christopher H.; Joshi, Atul; Lichtman, David M.

doi:10.5435/00124635-200103000-00006

Cited by 147 publications

(113 citation statements)

References 33 publications

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“…We attempted to answer the following questions: (1) What is the prevalence of incidental and symptomatic Kienböck disease? (2) What are the factors associated with incidental and symptomatic Kienböck disease?…”

Section: Introductionmentioning

confidence: 99%

What Is the Radiographic Prevalence of Incidental Kienböck Disease?

Leeuwen

Janssen

Meulen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Section: Introductionmentioning

confidence: 99%

What Is the Radiographic Prevalence of Incidental Kienböck Disease?

Leeuwen

Janssen

Meulen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…However, other reports stated that ulnar variance had no correlation with Kienbock's disease 14,15) . Moreover, the occurrence rates of ulnar negative variance in Kienbock's disease patients and the normal population were the same 12,16) . Han et al 17) .…”

Section: Resultsmentioning

confidence: 82%

“…Discussion Although scholars worldwide had studied Kienbock's disease for many years, the natural history and etiology remained unclear. Some studies found that ulnar negative variance was significantly correlated with Kienbock's disease 2,12,13) . However, other reports stated that ulnar variance had no correlation with Kienbock's disease 14,15) .…”

Section: Resultsmentioning

confidence: 99%

“…Han et al 17) . described the relationships between lunate morphology and ulnar length, and thought that the trabecular structures of lunate bones with different morphologies were different; thus, the weakest trabecular structure would be most prone to fatigue and stress fractures with loading, which tended to lead to bone necrosis 12,17,18) . Reduced blood supply to the lunate bone is a major contributor to Kienbock's disease.…”

Section: Resultsmentioning

confidence: 99%

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Biomechanical Comparison of Two Surgical Methods in Treating Stage IIIb Lunate Necrosis

Li¹,

Su²,

Xu³

et al. 2016

J. Hard Tissue Biology.

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This study aims to determine the biomechanical changes and basis for treatment using two surgical methods (scaphotrapeziotrapezoid [STT] fusion and capitoscaphoid [CS] fusion) for stage IIIb lunate necrosis. Eighteen fresh frozen upper extremities of adult cadavers were randomly divided into three groups. In group A, only the radioscaphoid and radiolunate spaces were exposed to place pressure sensors. Groups B and C underwent STT and CS fusion, respectively. The advanced I-scan pressure measurement system was used. Piezoelectric films were placed at the radioscaphoid and radiolunate spaces of wrist joints, and connected to the computerized I-scan system, which was then connected to a biaxial hydraulic material testing system (MTS). Pressure (up to 100 N) was applied to the wrist in inferior neutral position at a 10 N/s compression rate. The pressure distribution, pressure loading, and other data on the radioscaphoid and radiolunate articular surfaces for each sample were dynamically recorded and analyzed. After application of pressure with the wrist in neutral position, the radioscaphoid and radiolunate pressure values of the normal wrist group A were 41.39 ± 6.93 N/cm 2 and 39.22 ± 6.61 N/cm 2 , respectively; those of the STT arthrodesis group B were 83.89 ± 11.27 N/cm 2 and 22.55 ± 11.27 N/cm 2 ; and those of the SC arthrodesis group C were 86.45 ± 8.10 N/cm 2 and 34.11 ± 8.10 N/cm 2 . Compared with CS fusion, STT fusion surgery has much greater value in preventing rotatory semidislocation of the scaphoid bone, as well as in maintaining the stability of the wrist. It is the preferred surgical treatment for stage IIIb lunate necrosis.

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“…Common etiologies include posttraumatic [7], scapholunate advanced collapse (SLAC) [15], scaphoid nonunion advanced collapse (SNAC) [14], and late effects of avascular necrosis [1]. Arthritis of the radiocarpal joints results in pain, abnormal wrist biomechanics, and functional limitation for patients.…”

Section: Introductionmentioning

confidence: 99%

Joint Space Height Correlates with Arthroscopic Grading of Wrist Arthritis

Bear

Moloney

Goitz

et al. 2013

Hand (New York, N,Y.)

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Background Osteoarthritis of the radiocarpal joints is commonly encountered by hand surgeons. To date, there is no well-defined method of radiographically grading osteoarthritis of the wrist. Methods Preoperative radiographs of 48 patients undergoing wrist arthroscopy were evaluated retrospectively. Images were graded subjectively by five surgeons based on overall severity of arthritis, osteophytes, subchondral cysts, and subchondral sclerosis. The joint space height (JSH) ratio was calculated by measuring the space of the mid-radioscaphoid and mid-radiolunate joints and dividing each by the height of the capitate. Arthroscopic grading of arthritis was obtained from operative records and compared to subjective and objective grades. ANOVA testing evaluated for statistical significance with p<0.05. Inter-rater and intra-rater reliability was determined using Pearson's correlation analysis and Cohen's kappa coefficient. Results Objective measurement using the JSH ratio demonstrated a significant decrease as arthroscopic arthritis grade increased for both radioscaphoid and radiolunate joints. Subjective grading of radioscaphoid and radiolunate joints was able to detect moderate/severe, but not mild arthritis. Subjective grading underestimated the degree of arthritis, particularly in the radiolunate joint. Inter-rater reliability was better for objective compared to subjective grading. Conclusions Subjective grading of wrist arthritis can detect moderate/severe radiocarpal arthritis but poorly evaluates early arthritis and underestimates severity. Objective grading using the JSH ratio accurately grades radioscaphoid arthritis and detects early radiolunate arthritis. The JSH ratio more accurately assesses radiocarpal arthritis compared with subjective grading. As there currently is no accepted method to radiographically grade wrist arthritis, the JSH ratio represents a promising option.

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Kienböck’s Disease: Diagnosis and Treatment

Cited by 147 publications

References 33 publications

What Is the Radiographic Prevalence of Incidental Kienböck Disease?

What Is the Radiographic Prevalence of Incidental Kienböck Disease?

Biomechanical Comparison of Two Surgical Methods in Treating Stage IIIb Lunate Necrosis

Joint Space Height Correlates with Arthroscopic Grading of Wrist Arthritis

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