Primary results of Kienbock's disease treated using balloon kyphoplasty system

Kienbock's disease is difficult to treat and optimal treatments for stages II to III continue to elude investigators. We hypothesized that impacting the ischemic cancellous trabeculae and increasing the strength and rigidity of the lunate with balloon kyphoplasty can prevent lunate collapse, relieve the symptoms, and increase wrist range of motion. The purpose of this study was to demonstrate the feasibility of percutaneous balloon kyphoplasty for treatment of stage II to III Kienbock's disease. The study group comprised five patients (two in stage II, three in stage III). All were treated with balloon kyphoplasty. Pain, strength, and wrist flexion/extension range of motion were evaluated preoperatively and postoperatively. The Mayo Wrist Score and the Disabilities of the Arm, Shoulder and Hand (DASH) Score were used to evaluate outcomes. Patient satisfaction was also assessed. Comparisons between preoperative and postoperative data were made with SPSS software. Clinical data were collected at a mean of 26.6 months (range 24-28 months) postoperatively. Pain was significantly reduced from 6.8 +/- A 0.8 in the visual analog scale preoperatively to 0.6 +/- A 0.9 at the 24-month follow-up. Strength and range of motion were improved postoperatively in all patients. The mean DASH score was 11.3 (range 6.7-18.3), and the mean Mayo Wrist Score was 78 (range 75-80). All five patients returned to their previous occupations. Balloon kyphoplasty can prevent lunate collapse, reduce pain, and improve wrist function of patients with stage II to III Kienbock's disease. Further studies regarding the feasibility of this new approach are warranted.