title: Arthroscopic assisted bone grafting for early stages of Kienböck's disease.
abstract: Kienböck's disease is known for its difficulty in being diagnosed and treated at early stages; option treatments are few and most of them quite aggressive. The author describes his experience with arthroscopic assisted lunate bone grafting. Three patients with diagnosis of stage I avascular necrosis of the lunate (average age: 45 years), were treated. Before surgical procedure, the patients underwent to a conservative treatment. After harvesting the bone graft from the volar surface of the radius, arthroscopic bone grafting was performed. At an average follow-up of 13.5 months (9-15), all the patients show a normal density of the lunate and no arthritic changes in radiographs. The MRI confirmed the lunate vascularity. The number of patients is definitely small, due also to the rarity of the disease and the difficulty in diagnosis, but, despite the very high learning curve, could be the proper first choice of treatment.
authors.affiliation: Plastic Surgery Department, University of Milan Hand Unit, Policlinico Multimedica I.R.C.C.S., 20099 Sesto San Giovanni (Milano), Italy. lorispegoli@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Pegoli
authors.forename: A
authors.initials: A
authors.lastname: Ghezzi
authors.forename: E
authors.initials: E
authors.lastname: Cavalli
authors.forename: R
authors.initials: R
authors.lastname: Luchetti
authors.forename: G
authors.initials: G
authors.lastname: Pajardi
mesh_terms: D000328:Adult; D001175:Arthrography; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis / Q000601:surgery*; D011884:Radius / Q000637:transplantation*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome