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has anyone had surgery for kienbocks disease?

Hello,

i was diagnosed with Kienbock disease and have just had surgery a few days ago. I had never even heard of this disease until a few months ago. Does anyone have it?
23 Responses
Avatar universal
I was just diagnosed with Keinbock's disease and am weighing the options of surgery. What did you have? How did it go? How is your recovery? Do you have any information on what would happen if someone did not get surgery?

My saga is below:
I have been diagnosed with Keinbock's disease by a hand specialist and followed it with a second opinion by another hand specialist who concurred. I am a 60 year old WF in good enough health (meaning I'm a little overweight, active, and on no medications).

I sustained a bad thumb spring about 3 years ago and my wrist symptoms appeared about 2 years later. So, in July 2007 I noticed pain and swelling of the wrist after a day of gardening. I did the customary interventions of ice, antiinflamatories, and physical therapy before being diagnosed with Keinbock's in December 2008.

I am right hand dominant and it is my right hand that is effected. I am a college professor and talk and type for a living--to date my typing has not been overly effected. I am mainly treating it with a wrist splint and occasional tylenol. I wear the wrist splint 90% of the time including at night. I would say that I have a constant low level of manageable pain, and it seems to effect my entire arm/shoulder area (probably because I had some arm/shoulder pain before this diagnosis and it made it worse because of the limitations of the use of my hand).

The first hand specialist xrayed my hand and showed me the lunate bone which appeared bright white on the xray indicating that the bone had died. The second opinion said that pain usually occurs about 2 years after the bone dies and is associated when the bone actually begins to break up. I assume this was what I experienced in July 2007.

Both hand surgeons stressed "no cause, no cure". Althought instinctively I feel like it is related to several factors: a) I have small wrists; b) I like to do alot of manual labor; c) I sustained a bad thumb spring 3 years ago. Both surgeons said there were several surgeries but the general sense was that a wrist fusion would probably be the best solution.

Now to the questions:
1. What will happen if I don't do anything? Will it just keep getting worse and worse and eventually the pain will force me to do something? Is waiting bad and will it make it worse to wait by causing other damage in other parts of my hand?

2. What is the worst common thing that can go wrong with a wrist fusion surgery?

Any thoughts you have would be appreciated.
Sue Strong
Avatar universal
i just had surgery for keinbocks in may i had radial shortening i am going to therapy 2 times a week the pain isn't as bad as it was but i can't move my wrist up/down/or sideways not sure if i will get this movement back will see my surgeon 9/12 to find out any questions or comments are welcomed   good luck  moezoe
Avatar universal
I have just been diagnosed with keinbocks stage 3-4 lunate already collapsed. I was told that I was to late for early surgery's and not yet ready for fusion, did you find out what happens with no surgery?
Avatar universal
I was diagnosed with Kienbocks in February of 2004.  I first noticed it after I received what I thought was a sprain from my place of work.  It took at least two months before I really sought treatment   and was thought to have a torn ligament.  When I went to a hand specialist he had found that the Lunate was dying.  They did a radial shortening.  Went through therapy for six weeks.  I thought that did it until just after therapy my had became stiff and painful again.  When I went for a check up they found that the Lunate had disintegrated so they gave me three options at to what they could do.  With all three there seemed to be something that would cause a long term effect.  I choose to have the Proximalrow Carpectomy.  They removed all three bones.  Now more that 4 years later I have gradually lost the use of my hand.  I am unable to lift anything with the most minor of weight and to hold it forget it. Now I am to the point that even typing causes so much pain up my arm. Range of motion is minimal and I have pain that goes up mu Ulna bone to my elbow.  I am trying to get SS Disability because no one will hire me because I am a liability.  
I know that this may not bring you a solution to your problem but I just want you to know that you are not alone.  I too never heard about this until I was diagnosed.  I must say though even though I have pain and  discomfort I still have my hand.
Sincerely,
Darlene
Avatar universal
I'm a 21 year old female and I have this disease. To answer some of your questions. If you don't do anything about it it will get worse. There are different stages of it. Stage one is kind of like a sprang and the final stage four ends up being arthritis. Its not a disease to mess around with. My wrist went from just being in stage one on may 19th and two months later I'm in stage four. I'm having surgery8/1 due to it. I was in a splint for three months day in and day out and it never got better. Went to four different hand specialists and the last one finally did something about it. And the third one said I had this disease but said I needed to c a rhuematologist.. but finally Dr Perry at evansville Tri state orthopedic did something.    It is a very painful disease and I've yet to find a pain med to help it. Including meloxicam and ibuprofen 800.. you can also do physical therapy. Like accupunture to help relieve some pain.. I hope this is useful. And please from my experience don't let it go. It only gets more painful and worse
1 Comments
Hi, just wondering what as actually done to help? Have you since had any surgery, would you recommend it?
Avatar universal
I'm having surgery August first.. they're going to be doing numerous things. The surgery depends on what stage in your in. If you still haven't checked this out let me know what stage your in or what I've found out and I can let u know what will happen.
Avatar universal
I'm stage 4. Can you please tell me what are my options? thank you!
Avatar universal
I have stage I and I am in a cast. Haveany of you been given the bone stimulator to help with the healing?
Avatar universal
I have stage 2.
I am a 21 year old WF.
Previous right radial fracture 7 years ago.
Occupation: Waitress
Hurt for about 8 months until I went to doc.
Diagnosed with Stage 1.
Cast applied for 3 months.
Progressed to Stage 2.
Now I've been put in a Bone Stimulator Cast.
I go back in 7 weeks to decide on surgery if not healing.
I'll probably get revascularization bone graft.
Pain on a scale of 1-10 is a constant 6.
Throbbing/ stabbing pain.
Tender upon touch and swollen.
Can't move hand up or down.
Numbness in fingers increases monthly.

1 Comments
Hi, would love to know if the bone simulator cast worked
Avatar universal
I had kienbocks surgery it was horrible when I woke up I was in tears, with 4 pins in my hand under a cast for 6 weeks. doc cut me off pain meds, had me go to therapy when I still had a cast on cause my fingers were stiffening. Today I still have pains in my wrist daily. but it had to be done or fusion was the other option.
1 Comments
Hi, being 4 years on, how is your wrist now? No you think the surgery was successful?
7353995 tn?1390914601
I have stage 4 going for CT on Wednesday to see when my Full Fusion Date is, do not let it go get it checked early I was the stubborn type that kept pushing it off saying would be fine
7353995 tn?1390914601
So got the results not good but what expected the Lunate is collapsed and can see where breaking up. So full fusion here I come spoke to ortho and will be within 6 months need 2 weeks off work. she will be doing a Proximal row carpectomy and using those bones for the graft. so that's the update looking forward to being pain free and adapting to what will come my way
1 Comments
Hi, are you now pain free? Would you recommend that particular operation?
Avatar universal
I fell off the uneven bars in gym class back in 1979.  Sprained/fractured my wrist, in July of 1982 the surgeons at Walter Reed Medical Center replaced my lunate bone with a plastic bone.  They told me it would last approximately 10 years.  Well, now it is April of 2014 and the pain is finally to the point that I can not tolerate it any longer.  I am seeking a good hand specialist because I am going to have to have my wrist fused.  Kienbocks Disease is NOT to be played with.....take care of yourself.  When I now think back on it (I will be 50 this November) I think I would have had the fusion done back in 1982.  I have endured pain and swelling in my wrist my entire life.  It is not fun!!  Last summer I wore my brace so much that my arm was tan around it.  I NEVER sleep without it.  
Avatar universal
I haven't got Kienbocks, but I can give you some history, as I have assisted on a few. It was named after Dr. Robert Kienbock - he was a radiologist in Austria. Basically the lunate (articulates with the radius) dies and/ or fragments and/ or decompresses due to interrupted blood supply to this bone. Treatment is usually a wrist fusion. Best of luck!
Avatar universal
Hi All

Ive just been diagnosed with Kienbocks disease in my left wrist. This showed after an MRI as I was concerned that my wrist being in pain was not "just a sprain" as diagnosed by the doctors. luckily for me the disease is only at a stage one... "Thank goodness your an athlete that knows their body well" was my doctors response!! Last week I underwent keyhole surgery for my consultant to get a better picture of what is happening. They scraped out scar tissue and pierced a fluid sack. I went to see my consultant today and she said I need to go back in 6 weeks to discuss next steps. Revasclarization is an option or we can just leave it and "see how it goes". After reading the issues occurring from this disease developing I'm not convinced im happy leaving it especially as my wrists are crucial to my job. What does everybody think? Thanks in advance. Nik
7721494 tn?1431627964
I think you need to do what you need to do but you need to heal before anyone can make a prognosis on your future.

A practicing orthopaedic specialist can give you statistics that will guide your decisions, so stay with it. See what happens in 6 weeks -- if it feels like you are not healing, then call.

Let the bone heal and scar tissue dissolve -- then your doc can give you realistic options.

Follow instructions regarding movement of the wrist in this critical period. Ice and elevate to reduce swelling.

Six weeks passes quickly. Be patient.
Avatar universal
I was diagnosed with Stage 3 Keinbocks Disease. I had a radial shortening, and was off of work for nearly a year, and in physical therapy for 6 months, because I began to lose muscle mass in my arm. I work as a Cake Decorator, which is becoming more and more difficult to do. I am having another xray in a couple of weeks to see if the bone is healing, because the pain is becoming constant again. Has anyone had a full fusion? Are you able to work with it?
Avatar universal
Yeah I had my op a week ago and hadn't heard of it either the op isn't 100% it may not work but a chance I took to stop the pain
Avatar universal
I went to see an orthopedic Dr on 6 occasions over a two year period and he kept telling me that there is nothing wrong but he got me to consent to have injections into my wrist and during them he stopped and referred me for a MRI scan and after that I got sent to a new hospital and seen a new Dr who diagnosed me with stage 4 Kienbocks Disease. I had denavation if that's what it's called to try reduce this pain I had for almost 3 year now and when I was having that op the Dr put a scope in my arm but I was still in complete agony so had wrist fusion in October 2015 and guess what I'm still in pain  
1 Comments
I was diagnosed with stage 3 2 years ago. I wear a brace at night but other than that I live with it. I am choosing not to have surgery. I guess I will be the gunea pig and let you know what becomes of my wrist someday. I have carpal tunnel in my other wrist and a cervical herniated disc in my spine. Thetes too much to deal with. I see the few of us that have this disease get surgery and it leads to more surgery. No thanks!
Avatar universal
I have Kienbock's also, diagnosed about a year and half ago at late stage 2 early stage 3. I had a Radial Shortening Osteotomy 11 months ago and that helped for a while then the pain gradually came back. My Dr thought that because of the radial shortening pressure was added to the ulna side and causing pain so he decided to do a wafer procedure. The wafer is performed by going in arthroscopically and shaving down the head of the ulna bone to release pressure. But when he went in he saw that the ulna was fine and checked out the lunate which had died more and begun to collapse, so he did a lunate debridement. This procedure involves cutting all the dead tissue and bone of the lunate out until there is only hard bone left and was performed last month. He then he explained to me that this has a 50% chance of working but in my case he doesn't think it will, at which point I will need a proximal row carpectomy. My pain has increased more than it ever has before and it is more constant, so I guess I will be moving along to the next procedure. My point is this a very rare condition with not a lot of treatment options. It is degenerative and only gets worse but left untreated it will be much worse than if treated. So for the person that stated above that they elected to not have surgery I would strongly suggest you reconsider. What will eventually happen if untreated is the lunate will collapse, break apart into tiny shards and float around the wrist joint causing extreme pain and wrist/hand immobility and eventually arthritis will be added to the mix.    
1 Comments
Hello I have just recently ben diagnosed with kienbock disease in my left wrist and I am due to have the same operation as you go shorten the bone in my arm. Can I ask how long this helped you for? It is all new to me and I'm just trying to get my head around it
Avatar universal
I got diagnosed with late stage 3 just went thru surgery 2weeks ago with a lunate replacement. I will be in a cast for 8 weeks to hope the ligaments tighten to hold bone in place. Pain has been hard to control. Doctor is not to confident of this working but wanted to try this before a complete fusion because of my age.
2 Comments
May I ask how old you are? I am 25 and have been diagnosed with stage 2 and I'm having the bone in my arm shortened but if the joint is bad then I will be having the same as you but my surgeon also said he's not happy doing it at my age
Hello I am 33, after this post I ended up having a second surgery due to the fake bone slipping. They did a tendon graft hopefully I will get at least 50% ROM back. I still deal with pain daily . Only time will tell. It was to late in stage 3 for shortening as my lunate had pretty much completely collapsed by the time we found it
Avatar universal
I was diagnosed August 2017 with Keinsbock disease stage 3b Fri (Feb 16th) having radial shortening osteotomy. Hopefully it will alleviate the pain I continue to have. If not they will do a fusion of my wrist.
Avatar universal
I was diagnosed with Kienbock’s disease at age 14 and had to have a Radial Shortening Osteotomy a few weeks later. I am 20 now and although the pain that was in my lunate has subsided, I still get joint pain and have limited movement in my wrist. However, I have never been offered any physio. I have only recently started to become interested if other people have Kienbocks and the effects but it seems like I was quite young when I had this done. Anyone else have a radial shortening osteotomy for kienbocks?
1 Comments
I had this same surgery Feb 16 2018. As of today 7/8 it is still not healed.
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