Document Detail

A novel arthroscopic technique utilizing bone morphogenetic protein in the treatment of kienböck disease.
MedLine Citation:
PMID:  23423227     Owner:  NLM     Status:  In-Data-Review    
Kienböck disease, first described in 1910, is osteonecrosis of the carpal lunate and has been associated with ulnar minus variance. Numerous joint leveling procedures have been developed for patients with ulnar-negative variance to decrease forces transmitted across the lunate. The basis of operative treatment is the presence or absence of advanced osteoarthritis associated with fragmentation of the carpal lunate and capitate descent. Bone morphogenetic proteins (BMPs) have been utilized successfully as adjunctive treatment in fracture healing and recently in the surgical treatment of a patient with Lichtman stage IIIA Kienböck disease. Arthroscopy is an available tool in assessing cartilage injury and coupled with the use of BMP may be of benefit in patients with ulnar-neutral or ulnar-negative wrists who have not progressed to severe arthritis and capitate descent. We report a novel arthroscopic technique in which a stage IIIA and IIIB carpal lunate osteonecrosis is treated by curettage and grafting with an admixture of autologous radial cancellous bone marrow graft and BMP-2.
Rebecca A Rajfer; Jonathan R Danoff; Joshua A Metzl; Melvin P Rosenwasser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Techniques in hand & upper extremity surgery     Volume:  17     ISSN:  1531-6572     ISO Abbreviation:  Tech Hand Up Extrem Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9704676     Medline TA:  Tech Hand Up Extrem Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-6     Citation Subset:  IM    
Department of Orthopaedic Surgery, Columbia University College of Physicians & Surgeons, New York, NY.
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