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• W2513302351 abstract "There is no financial information to disclose. Kienböck disease is an aseptic necrosis of the lunate of unknown etiology, prevalent in young adults, and treatment aims to lower forces on the lunate, decrease pain and improve function. We conducted a retrospective evaluation of the 10-year clinical and radiological outcomes of radial osteotomy as a treatment for Kienböck disease. We analyzed pain, grip strength, wrist range of motion (ROM), radiological carpal geometry and staging of osteoarthritic changes under arthroscopy. Between 1993 and 2005, we identified 67 cases of unilateral Kienböck disease treated by radial osteotomy, with arthroscopic evaluation. Of these cases, 18 included a follow-up period over 10 years and formed our study group. The Mayo wrist score was used as an overall measure of outcome. Outcomes for 2 types of osteotomies were included: a step-cut osteotomy with fixed screws and an updated technique of 2 linear transverse osteotomies with volar plating using locked-plates. For cases with negative ulnar variance, resection of the radius was included to obtain a final ulnar variance of -1 to 0 mm. For positive ulnar variance, the goal was to obtain a correction of radial inclination of 10 degrees-15 degrees. Arthroscopic assessment was performed on the same day as the radial osteotomy, lesions of the articular cartilage were defined as softening, fibrillation, erosion, or defects of the joint cartilage, with an absence of lesions defined by a smooth appearance of the cartilage surface. All arthroscopic findings were classified in terms of the location of cartilage lesions. Improvements in pain, ROM and grip strength were maintained over the 10-year follow-up, without radiological improvement in geometry (carpal height ratio and Stahl’s index). Mild osteoarthritic changes were identified in 33% of patients, with no effect on clinical results. Degree of cartilage damage determined post-operative grip strength improvement. The Mayo wrist score at the final follow-up was excellent in 1 patient, good in 9, and fair in 8. •Radial osteotomy can decrease overload and mechanical malalignment of the lunate, and simultaneously improve the vascularity of the carpus and provides reasonable, long-term clinical benefits.•The clinical results were good at long-term follow-up, but the radiological improvement was not large.•Pre-operative arthroscopic evaluation of cartilage damage can inform treatment decisions." @default.
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• W2513302351 date "2016-09-01" @default.
• W2513302351 modified "2023-09-25" @default.
• W2513302351 title "Long-term Outcomes and Arthroscopic Assessments of Radial Osteotomy for Kienböck Disease" @default.
• W2513302351 doi "https://doi.org/10.1016/j.jhsa.2016.07.008" @default.
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