Arthroscopic debridement for the treatment of Kienbock's disease

The treatment results of seven patients (age range, 37 to 74 pears, male:fe male ratio, 1:6) with Kienbock's disease (Lichtman stage IIIA-IIIB) who und erwent arthroscopic debridement of the necrotic lunate bone and degenerativ e intrinsic ligaments were studied retrospectively. Osteoarthritic changes of the articular cartilage were documented in all cases, partial (n = 2) an d complete (n = 5) ruptures of the lunotriquetral and scapholunate ligament s, local synovitis In = 5), and loose fragments (n = 6) occurred most commo nly in the radiocarpal joint. All patients were available for an average of 19 months of follow-up (range, 6 to 42 months), physical examination, and radiographic evaluation. All patients reported significant improvement in p ain relief and complete relief of mechanical symptoms. Radiographs showed p rogression of the disease in three cases; two of these were followed-up for more than 2 years. Arthroscopy in Kienbock's disease allows direct visuali zation and assessment of the exact pathology of the radiocarpal and midcarp al joint and the lunate cartilage. Arthroscopic debridement of the necrotic lunate increased wrist functional range of motion, provided excellent pain relief, and improved health-related quality of Life in all patients.