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Erschienen in:
08.10.2016 | Original Paper
Lunate implant arthroplasty: analysis of physical function and patient satisfaction
Erschienen in: European Journal of Plastic Surgery | Ausgabe 3/2017
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Background
Avascular necrosis of the lunate has been the topic of debate for the last century. A relatively new treatment for a symptomatic patient with a Lichtman stage IIIB or stage IV is lunate pyrocarbon implant arthroplasty. The purpose of this study is to document the clinical outcomes and evaluate the results of this new modality.
Methods
A retrospective cohort study of patients with a symptomatic Kienböck’s disease stage IIIB treated by lunate pyrocarbon implant arthroplasty stabilized with a tendon graft. Presurgical and postsurgical assessment was performed including a questionnaire, X-ray, goniometric measurements, and grip strength.
Results
Between 2010 and 2013, 16 patients with a mean follow-up of 24 months were treated. Average VAS score improved from 5 to 2.6 and average PRHWE score from 58 to 24. The average flexion extension arc and wrist deviation arc were decreased 26 and 14 degrees. The average grip strength increased from 23 to 29. Most patients were very satisfied about the operation; 14 out of 16 would undergo the same procedure again, given the same circumstances.
Conclusions
Both the subjective and objective results are comparable to previous reported data of conventional treatments, and it may therefore be a suitable alternative to proximal row carpectomy (PRC). The implant lifespan is not known, but it could postpone the need for salvage procedures in young patients. Further research is needed to provide long-term outcomes and help guide future treatment of patients with Kienböck’s disease.
Level of evidence: Level IV, therapeutic study.