Decision-Making in Kienböck Disease

In 2016, the Journal of Wrist Surgery published the “Special Focus Section” papers on treatments for Kienböck disease. I set a title of “Kienböck Disease: Last Frontier of the Wrist” for this “Special Focus Section.” There are several difficult pathologies of the wrist, that is, carpal instability including scapholunate ligament injury, scaphoid fracture/nonunion, TFCC lesions, DRUJ instability, and Kienböck disease. Scaphoid fracture/nonunion and TFCC/DRUJ lesions are now well treated with either open or arthroscopic procedures. Chronic scapholunate ligament lesions with carpal instability are still difficult to treat, although several arthroscopic or open reconstructions for this pathology have been reported in a success in the literature. In Kienböck disease, pathologies are not well-introduced. Multiple papers on single treatment are reported with successful results, while we do not have well-conducted comparative, prospective studies as this disease is relatively rare. The Kienböck disease remains in the “last frontier of the wrist.”

This issue includes the “Special Review” of “Simplifying the decision-making process in the treatment of Kienböck's disease” by Drs Tee R., Butler S., Ek E., and Tham S. This review describes the comparison of MRI, CT, and arthroscopy in evaluating the lunate pathology and roles in the decision-making process for management of Kienböck disease. They concluded that management in adult Kienböck disease may be determined by the integrity of the lunate cortex by CT scan and decided whether the lunate is salvageable by MRI not by CT scan. Arthroscopy has a role in selective cases.

Interesting wrist scientific papers, such as the carpal instability, DRUJ arthroplasty, De Quervain synovitis, total wrist arthroplasty, reconstruction of the proximal pole of the scaphoid, unique case reports, procedure paper for arthroscopic repair of symptomatic radial-sided TFCC lesions and systematic review of partial scapholunate ligament injury are included in this issue. Don't miss it.

Publication History

Article published online:
17 July 2024