Abstract
Technical details and clinical results are reported of arthroscopic assisted bone grafting of the lunate, which is indicated in early stages of Kienbock’s disease. Using standard wrist arthroscopic technique, a cavity is created into the lunate by drilling its dorso-ulnar aspect and filled with cancellous bone harvested from the distal radial metaphysis. Five patients diagnosed Lichtman’s stage 1 and Bain and Begg’s grade 0 were treated and evaluated after a mean follow-up of 32 months. All patients reported an improvement of symptoms and function and showed good patient satisfaction. This is an advanced arthroscopic technique, which is a valuable addition to the treatment options of early Kienbock’s disease. It should be reserved for those cases in which the lunate morphology is preserved and articular surfaces are functional. This technique decompresses the lunate and adds new cancellous bone without burning any bridges.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bain GI, Begg M. Arthroscopic assessment and classification of Kienbock’s disease. Tech Hand Up Extrem Surg. 2006;10(1):8–13.
Menth-Chiari WA, Poehling GG, Wiesler ER, Ruch DS. Arthroscopic debridement for the treatment of Kienbock’s disease. Arthroscopy. 1999;15(1):12–9.
Lichtman DM, Alexander AH, Mack GR, Gunther SF. Kienbock’s disease. Update on silicone replacement arthroplasty. J Hand Surg Am. 1982;7:343–7.
Atzei A, Luchetti R, Sgarbossa A, Carità E, Llusà M. Set-up, portals and normal exploration in wrist arthroscopy. Chir Main. 2006;25:S131–44.
Schuind F, Eslami S, Ledoux P. Kienböck’s disease. J Bone Joint Surg Br. 2008;90:133–9.
Raven EE, Haverkamp D, Marti RK. Outcome of Kienböck’s disease 22 years after distal radius shortening osteotomy. Clin Orthop Relat Res. 2007;460:137–41.
Gay AM, Parratte S, Glard Y, Mutaftschiev N, Legre R. Isolated capitate shortening osteotomy for the early stage of Kienböck disease with neutral ulnar variance. Plast Reconstr Surg. 2009;124(2):560–6.
Lichtman DM, Roure AR. External fixation for the treatment of Kienböck’s disease. Hand Clin. 1993;9:691–7.
Jensen CH. Intraosseous pressure in Kienbock’s disease. J Hand Surg Am. 1993;18:355–9.
Illarramendi AA, Schulz C, De Carli P. The surgical treatment of Kienböck’s disease by radius and ulna metaphyseal core decompression. J Hand Surg Am. 2001;26:252–60.
Pegoli L, Ghezzi A, Cavalli E, Luchetti R, Pajardi G. Arthroscopic assisted bone grafting for early stages of Kienböck’s disease. Hand Surg. 2011;16(2):127–31.
Bain GI, Smith ML, Watts AC. Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):66–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Atzei, A., Pegoli, L. (2016). Arthroscopic Reconstructive Procedures for Kienböck’s Disease: Arthroscopic Assisted Bone Grafting. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_24
Download citation
DOI: https://doi.org/10.1007/978-3-319-34226-9_24
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-34224-5
Online ISBN: 978-3-319-34226-9
eBook Packages: MedicineMedicine (R0)