J Korean Orthop Assoc.
2024 Jun;59(3):174-183. 10.4055/jkoa.2024.59.3.174 .
Roles and Limitations of Arthroscopy in the Treatment of Kienböck’s Disease
- Affiliations
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- 1Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2556583
- DOI: http://doi.org/10.4055/jkoa.2024.59.3.174
Abstract
- Kienböck’s disease is an avascular necrosis of the lunate that can be accompanied by a lunate fracture. Although numerous studies on Kienböck’s disease have been conducted, its natural history is incompletely understood and there is no consensus for treatment. Various wrist arthroscopic surgeries have been attempted owing to the increasing interest in wrist minimal-invasive surgery. Traditionally, the Lichtman classification, based on the osseous status, is used widely to assess Kienböck’s disease. On the other hand, age, vascular condition, and cartilage status are also important when making a treatment plan for Kienböck’s disease. This article introduces a new classification and treatment algorithm combining osseous, vascular and cartilage classifications. Moreover, the roles and limitations of arthroscopy in this new algorithm are reviewed, and the author’s preferred treatment protocol based on staging is introduced.
