Kienböck's disease: current concepts
Abstract
Osteonecrosis of the lunate or Kienböck’s disease is a progressive, debilitating condition that can lead to chronic pain and function loss. Despite it was identification almost 100 years ago, the etiology remains unknown, although mechanical, vascular, and traumatic factors have been associated. The natural history of Kienböck’s disease is poorly defined, and the radiographic findings do not always correlate with the clinical findings. There has been some progress in identifying and understanding the progression of the avascular process and its deleterious effects on wrist mechanics. Initial treatment is conservative. Improvement in surgical techniques with vascularized bone grafts from the distal radius may lead to an outcome improvement for patients in the early stages of disease. However, more research is still needed to determine whether this surgical treatment represents an improvement over conventional treatment alternatives. Recent reports of long-term outcomes for radial shortening osteotomy in osteonecrosis early stage patients and for proximal row carpectomy (PRC) in advanced Kienböck’s disease patients reveal that these procedures provide reliable options for the long-term management of this challenging condition.Downloads
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