Kienböck disease, current issues

  • Pantelis K. Mitsikostas
  • Sofia A. Syngouna
  • Ioannis D. Aifantis
  • Ioannis S. Palavos
  • Sarantis G. Spyridonos
  • Filippos S. Giannoulis
Keywords: Kienbock disease, lunate, wrist

Abstract

Kienböck’s disease (KD) is a progressive condition leading to lunate collapse and carpal functionality disorder, with still uncertain etiology. The disease seems initially to affect the vascularity, lately the bone density and finally the cartilage of lunate. Advanced imaging and wrist arthroscopy offer useful tools for its approach. Classification, staging, therapeutic treatment and prognosis mostly depend on their findings. The cure algorithms that are usually followed include load redistribution, revascularization and lunate or wrist reconstruction as salvage surgery. Despite the great variation of operative options the majority of them provide satisfactory results.

Author Biographies

Pantelis K. Mitsikostas

1st Orthopaedic Department, KAT Hospital, Kifisia, Greece

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

Sofia A. Syngouna

3rd Orthopaedic Department, University of Athens, KAT Hospital, Kifisia, Greece

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

Ioannis D. Aifantis

2nd Orthopaedic Department, KAT Hospital, Kifisia, Greece

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

Ioannis S. Palavos

1st Orthopaedic Department, KAT Hospital, Kifisia, Greece

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

Sarantis G. Spyridonos

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

Filippos S. Giannoulis

Hand-Upper Limb & Microsurgery Department, KAT Hospital, Kifisia, Greece

References

1. Dumontier C. [Kienbock’s disease. Current data]. Annales de radiologie. 1992;35(5):373-83.
2. Irisarri C, Kalb K, Ribak S. Infantile and juvenile lunatomalacia. The Journal of hand surgery, European volume. 2010;35(7):544-8.
3. Thienpont E, Mulier T, Rega F, De Smet L. Radiographic analysis of anatomical risk factors for Kienbock’s disease. Acta orthopaedica Belgica. 2004;70(5):406-9.
4. Chung KC, Spilson MS, Kim MH. Is negative ulnar variance a risk factor for Kienbock’s disease? A meta-analysis. Annals of plastic surgery. 2001;47(5):494-9.
5. Gelberman RH, Bauman TD, Menon J, Akeson WH. The vascularity of the lunate bone and Kienbock’s disease. The Journal of hand surgery. 1980;5(3):272-8.
6. Schiltenwolf M, Martini AK, Mau HC, Eversheim S, Brocai DR, Jensen CH. Further investigations of the intraosseous pressure characteristics in necrotic lunates (Kienbock’s disease). The Journal of hand surgery. 1996;21(5):754-8.
7. Kim S, Eichenauer F, Asmus A, Mutze S, Eisenschenk A, Honigmann P. Superselective angiography of the wrist in patients with Kienbock’s disease. BMC musculoskeletal disorders. 2019;20(1):143.
8. De Smet L. Avascular necrosis of multiple carpal bones. A case report. Chirurgie de la main. 1999;18(3):202-4.
9. Irisarri C. [Aetiology of Kienbock’s Disease]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse 2010;42(3):157-61.
10. Lichtman DM, Degnan GG. Staging and its use in the determination of treatment modalities for Kienbock’s disease. Hand clinics. 1993;9(3):409-16.
11. Lichtman DM, Lesley NE, Simmons SP. The classification and treatment of Kienbock’s disease: the state of the art and a look at the future. The Journal of hand surgery, European volume. 2010;35(7):549-54.
12. Schmitt R, Heinze A, Fellner F, Obletter N, Struhn R, Bautz W. Imaging and staging of avascular osteonecroses at the wrist and hand. European journal of radiology. 1997;25(2):92-103.
13. Schmitt R, Kalb K. [Imaging in Kienbock’s Disease]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse 2010;42(3):162-70.
14. Bain GI, Begg M. Arthroscopic assessment and classification of Kienbock’s disease. Techniques in hand & upper extremity surgery. 2006;10(1):8-13.
15. Lichtman DM, Pientka WF, 2nd, Bain GI. Kienbock Disease: A New Algorithm for the 21st Century. Journal of wrist surgery. 2017;6(1):2-10.
16. Chevrollier J, Pomares G, Huguet S, Dap F, Dautel G. Intracarpal shortening osteotomy for Kienbock’s disease: A retrospective study of 28 cases. Orthopaedics & traumatology, surgery & research : OTSR. 2017;103(2):191-8.
17. Yildirim AM, Piskin A, Karaismailoglu B, Sener M. Functional and radiological results of partial capitate shortening osteotomy in the treatment of Kienbock’s disease. The Journal of hand surgery, European volume. 2020:1753193420905991.
18. Jorge-Mora A, Pretell-Mazzini J, Marti-Ciruelos R, Andres-Esteban EM, Curto de la Mano A. Distal radius definitive epiphysiodesis for management of Kienbock s disease in skeletally immature patients. International orthopaedics. 2012;36(10):2101-5.
19. Fontaine C. Kienbock’s disease. Chirurgie de la main. 2015;34(1):4-17.
20. Tsantes AG, Papadopoulos DV, Gelalis ID, Vekris MD, Pakos EE, Korompilias AV. The Efficacy of Vascularized Bone Grafts in the Treatment of Scaphoid Nonunions and Kienbock Disease: A Systematic Review in 917 Patients. Journal of hand and microsurgery. 2019;11(1):6-13.
21. Bain GI, Smith ML, Watts AC. Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Techniques in hand & upper extremity surgery. 2011;15(1):66-9.
22. Menth-Chiari WA, Poehling GG, Wiesler ER, Ruch DS. Arthroscopic debridement for the treatment of Kienbock’s disease. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1999;15(1):12-9.
23. Burger HK, Windhofer C, Gaggl AJ, Higgins JP. Vascularized medial femoral trochlea osteocartilaginous flap reconstruction of proximal pole scaphoid nonunions. The Journal of hand surgery. 2013;38(4):690-700.
24. Higgins JP, Burger HK. Osteochondral flaps from the distal femur: expanding applications, harvest sites, and indications. Journal of reconstructive microsurgery. 2014;30(7):483-90.
25. Vallejo EC, Martinez-Galdamez M, Martin ES, de Gregorio AP, Gallego MG, Escobar AR. Percutaneous Cementoplasty for Kienbock’s Disease. Cardiovascular and interventional radiology. 2017;40(5):793-8.
26. Bellemere P, Maes-Clavier C, Loubersac T, Gaisne E, Kerjean Y, Collon S. Pyrocarbon interposition wrist arthroplasty in the treatment of failed wrist procedures. Journal of wrist surgery. 2012;1(1):31-8.
27. Kato H, Usui M, Minami A. Long-term results of Kienbock’s disease treated by excisional arthroplasty with a silicone implant or coiled palmaris longus tendon. The Journal of hand surgery. 1986;11(5):645-53.
28. Saffar P. [Vascularized pisiform transfer in place of lunatum for Kienbock’s disease]. Chirurgie de la main. 2010;29 Suppl 1:S112-8.
29. Viljakka T, Vastamaki M, Solonen KA, Tallroth K. Silicone implant arthroplasty in Kienbock’s disease. Acta orthopaedica Scandinavica. 1987;58(4):410-4.
30. Werthel JD, Hoang DV, Boyer P, Dallaudiere B, Massin P, Loriaut P. [Treatment of Kienbock’s disease using a pyrocarbon implant: case report]. Chirurgie de la main. 2014;33(6):404-9.
31. Xie MM, Tang KL, Yuan CS. 3D printing lunate prosthesis for stage IIIc Kienbock’s disease: a case report. Archives of orthopaedic and trauma surgery. 2018;138(4):447-51.
32. Bain GI, MacLean SB, Tse WL, Ho PC, Lichtman DM. Kienbock Disease and Arthroscopy: Assessment, Classification, and Treatment. Journal of wrist surgery. 2016;5(4):255-60.
33. MacLean SBM, Kantar K, Bain GI, Lichtman DM. The Role of Wrist Arthroscopy in Kienbock Disease. Hand clinics. 2017;33(4):727-34.
34. Braga-Silva J, Roman JA, Padoin AV. Wrist denervation for painful conditions of the wrist. The Journal of hand surgery. 2011;36(6):961-6.
35. Schweizer A, von Kanel O, Kammer E, Meuli-Simmen C. Long-term follow-up evaluation of denervation of the wrist. The Journal of hand surgery. 2006;31(4):559-64.
Published
2020-07-27