Arthroscopic reconstructive procedures for kienböck’s disease: Arthroscopic assisted bone grafting

Abstract

Technical details and clinical results are reported of arthroscopic assisted bone grafting of the lunate, which is indicated in early stages of Kienbock’s disease. Using standard wrist arthroscopic technique, a cavity is created into the lunate by drilling its dorso-ulnar aspect and filled with cancellous bone harvested from the distal radial metaphysis. Five patients diagnosed Lichtman’s stage 1 and Bain and Begg’s grade 0 were treated and evaluated after a mean follow-up of 32 months. All patients reported an improvement of symptoms and function and showed good patient satisfaction. This is an advanced arthroscopic technique, which is a valuable addition to the treatment options of early Kienbock’s disease. It should be reserved for those cases in which the lunate morphology is preserved and articular surfaces are functional. This technique decompresses the lunate and adds new cancellous bone without burning any bridges.