Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

Patrick Q. Wang; Bogdan A. Matache; Ruby Grewal; Nina Suh

doi:10.1055/s-0040-1716353

Journal of Wrist Surgery, Table of Contents

J Wrist Surg 2020; 9(06): 535-548
DOI: 10.1055/s-0040-1716353

Survey or Meta-analysis

Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

Authors

Patrick Q. Wang

¹Department of Orthopaedic Surgery, University of Western Ontario, London, Ontario, Canada
Bogdan A. Matache

²Department of Hand and Upper Limb, St. Joseph's Health Care Centre, Roth MacFarlane Hand and Upper Limb Centre, University of Western Ontario, London, Ontario, Canada
Ruby Grewal

¹Department of Orthopaedic Surgery, University of Western Ontario, London, Ontario, Canada

²Department of Hand and Upper Limb, St. Joseph's Health Care Centre, Roth MacFarlane Hand and Upper Limb Centre, University of Western Ontario, London, Ontario, Canada
Nina Suh

¹Department of Orthopaedic Surgery, University of Western Ontario, London, Ontario, Canada

²Department of Hand and Upper Limb, St. Joseph's Health Care Centre, Roth MacFarlane Hand and Upper Limb Centre, University of Western Ontario, London, Ontario, Canada

Abstract

Background Despite numerous proposed surgical interventions, there is a lack of consensus in the optimal treatment of advanced Kienbock's disease.

Purpose This study aims to perform a systematic review of the current evidence in the management of Lichtman's stages IIIA and IIIB of the disease.

Methods A literature search was performed using the MEDLINE, EMBASE, and COCHRANE databases to identify studies between 2008 and 2018 evaluating stage-specific outcomes in Lichtman's stages IIIA and IIIB. The quality of each included paper was evaluated using the Structured Effectiveness Quality Evaluation Scale (SEQES). Data extracted were stage-specificity, clinical and functional outcomes, and radiographic progression of Lichtman's staging.

Results A total of 1,489 titles were identified. Eighty-three papers were fully reviewed, and 30 articles met eligibility criteria for inclusion. There were 3 low-quality and 27 moderate-quality papers. Surgical techniques reported included decompression surgeries, joint-levelling, and radial wedge osteotomies, revascularization techniques, intracarpal arthrodesis, proximal row carpectomy, arthroplasty, and balloon kyphoplasty. All treatment modalities offered pain relief and improvement in functional outcomes. Compared with proximal row carpectomy, intracarpal arthrodesis, and arthroplasty, nonsalvage procedures provided similar clinical and functional outcomes in both stages, with joint-levelling and radial wedge osteotomies preserving greater range of motion.

Conclusion In this systematic review of Kienbock's disease stages IIIA and IIIB, all treatment modalities provided positive outcomes. In stage IIIB, there is evidence to support nonsalvage procedures, as they produced similar clinical outcomes to salvage procedures that have the advantage of not precluding future treatment options if needed and preserving greater range of motion.

Keywords

Kienbock's disease - lunatomalacia - avascular necrosis of the lunate - aseptic necrosis of the lunate - Lichtman's classification

Full Text

References

References
1 Schuind F, Eslami S, Ledoux P. Kienbock's disease. J Bone Joint Surg Br 2008; 90 (02) 133-139
2 Innes L, Strauch RJ. Systematic review of the treatment of Kienböck's disease in its early and late stages. J Hand Surg Am 2010; 35 (05) 713-717 , 717.e1–717.e4
3 Danoff JR, Cuellar DO, , O J, Strauch RJ. The management of Kienböck disease: a survey of the ASSH membership. J Wrist Surg 2015; 4 (01) 43-48
4 Stahl S, Santos Stahl A, Rahmanian-Schwarz A. et al. An international opinion research survey of the etiology, diagnosis, therapy and outcome of Kienböck's disease (KD). Chir Main 2012; 31 (03) 128-137
5 Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed.. Edinburgh, Scotland: Churchill Livingstone; 2000
6 Truong JL, Doherty C, Suh N. The effect of socioeconomic factors on outcomes of distal radius fractures: a systematic review. Hand (N Y) 2018; 13 (05) 509-515
7 Fogarty S, Wardle J. Integrative medicine case series: a clinician's guide to publication. Adv Integr Med 2015; 2 (03) 147-151
8 Fouly EH, Sadek AF, Amin MF. Distal capitate shortening with capitometacarpal fusion for management of the early stages of Kienböck's disease with neutral ulnar variance: case series. J Orthop Surg Res 2014; 9 (01) 86
9 Okubo H, Futenma C, Sunagawa H, Kinjo M, Kanaya F. Very distal radius wedge osteotomy for Kienböck's disease: case series. J Hand Surg Asian Pac Vol 2017; 22 (04) 490-496
10 Facca S, Gondrand I, Naito K, Lequint T, Nonnenmacher J, Liverneaux P. Graner's procedure in Kienböck disease: a series of four cases with 25years of follow-up. Chir Main 2013; 32 (05) 305-309
11 Chen W, Wang J, Pan J, Zhang Q, Shao X, Zhang Y. Primary results of Kienböck's disease treated using balloon kyphoplasty system. Arch Orthop Trauma Surg 2012; 132 (05) 677-683
12 Ogawa T, Ochiai N, Nishiura Y, Tanaka T, Hara Y. A new treatment strategy for Kienböck's disease: combination of bone marrow transfusion, low-intensity pulsed ultrasound therapy, and external fixation. J Orthop Sci 2013; 18 (02) 230-237
13 Matsumoto T, Kakinoki R, Ikeguchi R, Ohta S, Akagi M, Matsuda S. Vascularized bone graft to the lunate combined with temporary scaphocapitate fixation for treatment of stage III Kienböck disease: a report of the results, a minimum of 2 years after surgery. J Hand Surg Am 2018; 43 (08) 773.e1-773.e7
14 Hohendorff B, Mühldorfer-Fodor M, Kalb K, van Schoonhoven J, Prommersberger KJ. STT arthrodesis versus proximal row carpectomy for Lichtman stage IIIB Kienböck's disease: first results of an ongoing observational study. Arch Orthop Trauma Surg 2012; 132 (09) 1327-1334
15 Hudak PL, Amadio PC, Bombardier C. The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996; 29 (06) 602-608
16 Beaton DE, Wright JG, Katz JN. Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87 (05) 1038-1046
17 Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 1987; (214) 136-147
18 Koh S, Nakamura R, Horii E, Nakao E, Inagaki H, Yajima H. Surgical outcome of radial osteotomy for Kienböck's disease-minimum 10 years of follow-up. J Hand Surg Am 2003; 28 (06) 910-916
19 Croog AS, Stern PJ. Proximal row carpectomy for advanced Kienböck's disease: average 10-year follow-up. J Hand Surg Am 2008; 33 (07) 1122-1130
20 Visser NJ, de Wijn RS, Moojen TM, Feitz R. Lunate implant arthroplasty: analysis of physical function and patient satisfaction. Eur J Plast Surg 2016; 40: 229-2349
21 Afshar A, Mehdizadeh M, Khalkhali H. Short-term clinical outcomes of radial shortening osteotomy and capitates shortening osteotomy in Kienböck disease. Arch Bone Jt Surg 2015; 3 (03) 173-178
22 Afshar A, Eivaziatashbeik K. Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease. J Hand Surg Am 2013; 38 (02) 289-296
23 Singer MS, Essawy OM, Farag HE. Early results of partial capitate shortening osteotomy in management of Kienböck disease. Curr Orthop Pract 2017; 28: 297-302
24 Gay AM, Parratte S, Glard Y, Mutaftschiev N, Legre R. Isolated capitate shortening osteotomy for the early stage of Kienböck disease with neutral ulnar variance. Plast Reconstr Surg 2009; 124 (02) 560-566
25 Osada D, Tamai K, Takai M. et al. Radial shortening osteotomy using volar locking plate for Kienböck's disease. Dokkyo J Med Sci. 2012; 39: 9-15
26 Watanabe T, Takahara M, Tsuchida H, Yamahara S, Kikuchi N, Ogino T. Long-term follow-up of radial shortening osteotomy for Kienbock disease. J Bone Joint Surg Am 2008; 90 (08) 1705-1711
27 Park IJ, Kim HM, Lee JY. et al. Treatment of Kienböck's disease using a fourth extensor compartmental artery as a vascularized pedicle bone graft. J Plast Reconstr Aesthet Surg 2016; 69 (10) 1403-1410
28 Bürger HK, Windhofer C, Gaggl AJ, Higgins JP. Vascularized medial femoral trochlea osteochondral flap reconstruction of advanced Kienböck disease. J Hand Surg Am 2014; 39 (07) 1313-1322
29 Buluç L, Gündeş H, Baran T, Selek Ö. Proximal row carpectomy for Lichtman stage III Kienböck's disease. Acta Orthop Traumatol Turc 2015; 49 (06) 641-647
30 Rodrigues-Pinto R, Freitas D, Costa LD. et al. Clinical and radiological results following radial osteotomy in patients with Kienböck's disease: four- to 18-year follow-up. J Bone Joint Surg Br 2012; 94 (02) 222-226
31 Fujiwara H, Oda R, Morisaki S, Ikoma K, Kubo T. Long-term results of vascularized bone graft for stage III Kienböck disease. J Hand Surg Am 2013; 38 (05) 904-908
32 Özdemir G, Akgül T, Çiçekli Ö, Yılmaz B, Atbinici H, Yücel F. Lunatum excision and scaphocapitate arthrodesis in Kienböck's disease. J Orthop Surg (Hong Kong) 2017; 25 (01) 2309499017692704
33 Xu Y, Li C, Zhou T. et al. Treatment of aseptic necrosis of the lunate bone (Kienböck disease) using a nickel-titanium memory alloy arthrodesis concentrator: a series of 24 cases. Medicine (Baltimore) 2015; 94 (42) e1760
34 Calfee RP, Van Steyn MO, Gyuricza C, Adams A, Weiland AJ, Gelberman RH. Joint leveling for advanced Kienböck's disease. J Hand Surg Am 2010; 35 (12) 1947-1954
35 Lee JS, Park MJ, Kang HJ. Scaphotrapeziotrapezoid arthrodesis and lunate excision for advanced Kienböck disease. J Hand Surg Am 2012; 37 (11) 2226-2232
36 Luegmair M, Saffar P. Scaphocapitate arthrodesis for treatment of late stage Kienbock disease. J Hand Surg Eur Vol 2014; 39 (04) 416-422
37 Viljakka T, Tallroth K, Vastamäki M. Long-term clinical outcome after titanium lunate arthroplasty for Kienböck disease. J Hand Surg Am 2018; 43 (10) 945.e1-945.e10
38 Mozaffarian K, Namazi H, Namdari A. Radial shortening osteotomy in advanced stages of Kienbock disease. Tech Hand Up Extrem Surg 2012; 16 (04) 242-246
39 Tatebe M, Koh S, Hirata H. Long-term outcomes of radial osteotomy for the treatment of Kienböck disease. J Wrist Surg 2016; 5 (02) 92-97
40 Matsuhashi T, Iwasaki N, Kato H, Minami M, Minami A. Clinical outcomes of excision arthroplasty for Kienbock's disease. Hand Surg 2011; 16 (03) 277-282
41 Chim H, Moran SL. Long-term outcomes of proximal row carpectomy: a systematic review of the literature. J Wrist Surg 2012; 1 (02) 141-148
42 Nakamura R, Imaeda T, Miura T. Radial shortening for Kienböck's disease: factors affecting the operative result. J Hand Surg [Br] 1990; 15 (01) 40-45
43 Iwasaki N, Minami A, Oizumi N, Yamane S, Suenaga N, Kato H. Predictors of clinical results of radial osteotomies for Kienböck's disease. Clin Orthop Relat Res 2003; (415) 157-162
44 Shin YH, Kim J, Gong HS, Rhee SH, Cho MJ, Baek GH. Clinical outcome of lateral wedge osteotomy of the radius in advanced stages of Kienböck's disease. Clin Orthop Surg 2017; 9 (03) 355-362
45 Shin YH, Kim JK, Han M, Lee TK, Yoon JO. Comparison of long-term outcomes of radial osteotomy and nonoperative treatment for Kienböck disease: a systematic review. J Bone Joint Surg Am 2018; 100 (14) 1231-1240
46 Illarramendi AA, Schulz C, De Carli P. The surgical treatment of Kienböck's disease by radius and ulna metaphyseal core decompression. J Hand Surg Am 2001; 26 (02) 252-260
47 Nakamura R, Watanabe K, Tsunoda K, Miura T. Radial osteotomy for Kienböck's disease evaluated by magnetic resonance imaging. 24 cases followed for 1-3 years. Acta Orthop Scand 1993; 64 (02) 207-211
48 Squitieri L, Petruska E, Chung KC. Publication bias in Kienböck's disease: systematic review. J Hand Surg Am 2010; 35 (03) 359-367.e5
49 De Carli P, Zaidenberg EE, Alfie V, Donndorff A, Boretto JG, Gallucci GL. Radius core decompression for Kienböck disease stage IIIA: outcomes at 13 years follow-up. J Hand Surg Am 2017; 42 (09) 752.e1-752.e6
50 Waitayawinyu T, Chin SH, Luria S, Trumble TE. Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienböck's disease in the ulnar positive wrist. J Hand Surg Am 2008; 33 (08) 1267-1273