BACKGROUND
Kienböck’s disease, characterized by avascular necrosis of the lunate, remains a therapeutic challenge. Radial core decompression (RCD) has emerged as a joint-preserving option to halt disease progression by improving vascularity. This study evaluates the functional and radiological outcomes of RCD in patients with Kienböck’s disease.
METHODS
A retrospective analysis was conducted on patients diagnosed with Kienböck’s disease who underwent radial core decompression. All patients underwent radiological evaluation using plain radiographs and/or MRI, and were categorized according to Lichtman staging. Functional outcomes were assessed using grip strength, range of motion (ROM), and patient-reported scores including the Disabilities of the Arm, Shoulder and Hand (DASH) and Visual Analog Scale (VAS). Radiological progression was assessed on follow-up imaging.
RESULTS
Fourteen patients were included, with a mean age of 28.6 years. Based on Lichtman staging, 4 patients were Stage I, 8 were Stage II, and 2 were Stage IIIA. At a mean follow-up of 18 months, patients reported significant pain relief, with a mean VAS reduction of 5.1 points. Grip strength improved by 85–95%, and ROM increased to a mean of 105°. Radiologically, 85.71% of cases showed no further lunate collapse, while 14.29% exhibited stable disease without progression. No patient demonstrated stage progression during follow-up.
CONCLUSION
RCD demonstrates promising mid-term functional and radiological outcomes in Kienböck’s disease, especially in early-stage cases. It may serve as a viable alternative to more invasive procedures, though longer-term studies are warranted.
KEYWORDS
Avascular necrosis, Kienböck’s disease, lunate, functional outcomes, radial core decompression, radiological outcomes