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Arthroscopic debridement for the treatment of Kienbock's disease.

Abstract
The treatment results of seven patients (age range, 37 to 74 years, male:female ratio, 1:6) with Kienbock's disease (Lichtman stage IIIA-IIIB) who underwent arthroscopic debridement of the necrotic lunate bone and degenerative intrinsic ligaments were studied retrospectively. Osteoarthritic changes of the articular cartilage were documented in all cases. Partial (n = 2) and complete (n = 5) ruptures of the lunotriquetral and scapholunate ligaments, local synovitis (n = 5), and loose fragments (n = 6) occurred most commonly in the radiocarpal joint. All patients were available for an average of 19 months of follow-up (range, 6 to 42 months), physical examination, and radiographic evaluation. All patients reported significant improvement in pain relief and complete relief of mechanical symptoms. Radiographs showed progression of the disease in three cases; two of these were followed-up for more than 2 years. Arthroscopy in Kienbock's disease allows direct visualization and assessment of the exact pathology of the radiocarpal and midcarpal joint and the lunate cartilage. Arthroscopic debridement of the necrotic lunate increased wrist functional range of motion, provided excellent pain relief, and improved health-related quality of life in all patients.
AuthorsW A Menth-Chiari, G G Poehling, E R Wiesler, D S Ruch
JournalArthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) 1999 Jan-Feb Vol. 15 Issue 1 Pg. 12-9 ISSN: 0749-8063 [Print] United States
PMID10024028 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Aged
  • Arthrography
  • Arthroscopy
  • Cartilage, Articular (diagnostic imaging, pathology, surgery)
  • Debridement (methods)
  • Endoscopy (methods)
  • Female
  • Follow-Up Studies
  • Humans
  • Ligaments, Articular (diagnostic imaging, pathology, surgery)
  • Male
  • Middle Aged
  • Osteochondritis (complications, diagnosis, surgery)
  • Osteonecrosis (complications, diagnosis, surgery)
  • Range of Motion, Articular
  • Retrospective Studies
  • Rupture, Spontaneous
  • Severity of Illness Index
  • Treatment Outcome
  • Wrist (physiopathology, surgery)

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