Introduction: Kienbock disease is defined by avascular necrosis of the lunate bone. If left untreated, the condition often progresses, leading to bone collapse, wrist shortening, and the need for ankle fusion. In this study, we performed a novel surgical method for treating Kienbock disease. We evaluated and compared the outcomes of lunate decompression with and without bone marrow injection in patients affected by Kienbock disease.
Method: In this study, 20 patients with Kienbock disease stages I to IIIa were assessed in two groups: one group received core lunate decompression. In contrast, the other group underwent core lunate decompression followed by an injection of bone marrow. This study took place from April 2015 to April 2016. The researchers assessed the patient's pain levels, range of motion, functional disability, and radiographic indices before and one year after the procedure.
Result: The average age of patients in the Bone Marrow (BM) group was 35.66 years (standard deviation: 13.02), compared to 30.33 years (standard deviation: 0.66) in the control group (P = 0.126). The mean postoperative Mayo score for the BM group was 88.12 (standard deviation: 6.51), while the control group had a mean score of 76.66 (standard deviation: 2.88) (P = 0.126). Additionally, the mean postoperative performance score in the BM group was 24.37 (standard deviation: 1.76), compared to 18.33 (standard deviation: 2.88) in the control group (P = 0.09). Bone vascularization and mineralization were more significant in the BM group than in the control group.
Conclusion: The results of this study indicate that core lunate decompression is an effective treatment for Kienbock disease. The outcomes in the BM group were significantly better than those in the control group. Additionally, improvements in bone density and radiological changes were observed in the BM group. However, further studies with larger sample sizes and longer follow-up durations are necessary for a more comprehensive evaluation of the BM treatment.