Osteotomies, Core Decompression, and Denervation for the Treatment of Kienböck Disease

Tadisina, Kashyap Komarraju; Pet, Mitchell A.

doi:10.1016/j.hcl.2022.03.006

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Opening channels for re-vascularization of the femoral head via core decompression has been seen as a working strategy for decreasing intra-osseous pressure in the initial stage of AVN [ 6 , 31 ]. Arthroscopic intra-articular decompression prevents femoral head collapse by removing loose bodies and debris from the joint space.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of arthroscopic synovectomy and core decompression through multiple small bone holes for early-stage avascular necrosis of the femoral head

Luo

et al. 2023

Arthroplasty

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Objective This study described a minimally invasive approach for the management of early-stage avascular necrosis of the femoral head, which integrated arthroscopic intra-articular decompression and core decompression by drilling multiple small holes. Method A total of 126 patients with 185 hip avascular necrosis were included between March 2005 and January 2008, and the hips were classified, based on the Association Research Circulation Osseous staging system, into stage I (n = 43), stage II (n = 114), and stage III (n = 28). Arthroscopic intra-articular inspection and debridement, along with drilling of multiple small holes for core decompression, were performed. The Modified Harris hip score system and radiographs were used to assess the pre- and post-surgery outcomes. Results One hundred and three patients (involving 153 hips) were followed up successfully for an average of 10.7 ± 3.4 years (range: 9–12 years). After surgery, the overall survival rate was 51.6% (79 hips), and the clinical survival rates were 79%, 72%, 52%, 32%, and 10% for patients with stage I, IIa, IIb, IIc, and III, respectively. The outcomes of patients with Association Research Circulation Osseous Stages I or IIA were better than those of other stages, while hips with a large necrotic area had poor results. This approach preserved the original biomechanical strength of the femoral head after core decompression and eliminated arthritis factors in the hip joint. Conclusion The core decompression with multiple small-size holes is an effective method for treating early-stage avascular necrosis of the femoral head, particularly in those with pathological changes in the hip joint. Level of evidence Therapeutic study, Level IV.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes of arthroscopic synovectomy and core decompression through multiple small bone holes for early-stage avascular necrosis of the femoral head

Luo

et al. 2023

Arthroplasty

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Outcomes of wrist denervation and core decompression of the radius for Kienbock's disease

Forrester,

Tedesco,

Geiger

et al. 2024

Journal of Hand and Microsurgery

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Clinical report of microsurgical treatment of Kohler's disease

Pei,

Zhu,

et al. 2024

Sci Rep

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The conservative treatment for Kohler's disease will take several months, but some patients still have flatfoot and persistent pain. From October 2013 to July 2015, 3 children with Kohler's disease underwent navicular decompression and micro-circulation reconstruction surgery in our hospital. All the patients have received conservative treatment for more than 3 months and the effect was poor. X-ray showed the bone density of navicular increased significantly. All patients were followed up over 1 year. The 3 patients recovered well. VAS score decreased from 7.0 to 2.6 at 1 month after the operation. The pain symptom disappeared completely on 3 months after surgery. The density of navicular bone recovered to normal. Navicular decompression and micro-circulation reconstruction surgery may quickly improve the ischemic status of navicular bone, alleviate pain symptom and enable patients to resume normal activity as soon as possible.

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Osteotomies, Core Decompression, and Denervation for the Treatment of Kienböck Disease

Cited by 3 publications

References 31 publications

Long-term outcomes of arthroscopic synovectomy and core decompression through multiple small bone holes for early-stage avascular necrosis of the femoral head

Long-term outcomes of arthroscopic synovectomy and core decompression through multiple small bone holes for early-stage avascular necrosis of the femoral head

Outcomes of wrist denervation and core decompression of the radius for Kienbock's disease

Clinical report of microsurgical treatment of Kohler's disease

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