Question:Ten years ago, I had surgery for KienbÃ¶ck's disease. The surgeon took a row of bones out of my left wrist. It seems to be holding up pretty well. There's a few things I have to be careful about like lifting. Otherwise, I'm pleased. How long will I still have good function in that hand after a surgery like this? Should I expect to get arthritis in that wrist?
Answer:KienbÃ¶ck's disease is a fairly rare condition of deterioration in the wrist caused by a loss of blood supply to the area. The lunate bone along the little finger side of the wrist (next to the forearm) is affected.
Removing the lunate and/or the entire row of carpal (wrist) bones is one way to manage the problem. This latter procedure is called a proximal row carpectomy (PRC).
There aren't very many studies to go on to answer your question. When studies are presented on PRC, patients included don't always have Kienbock's. Sometimes the studies are reporting on the use of PRC with a variety of wrist pain problems.
One long-term study from the University of Wisconsin offers some insight with a small number of patients. All had PRC for advanced KienbÃ¶ckâs disease. Follow-up was carried out for a minimum of 10 years. Data for some patients is available for up to 20 years.
Overall the results were good to excellent. The patients all reported decreased pain and improved grip strength and function. X-rays showed some joint degeneration but the patients were not having symptoms to suggest a problem.
Based on the small number of studies published, unless some other injury occurs, there's no reason to suspect your situation will change.Boyd C. Lumsden, MD, et al. Treatment of Advanced-Stage KienbÃ¶ck's Disease with Proximal Row Carpectomy: An Average 15-Year Follow-Up. In The Journal of Hand Surgery. April 2008. Vol. 33A. No. 4. Pp. 493-502.
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