This is a prospective randomized study examining the results in 16 consecutive patients who presented with Stage IIIA and Stage IIIB Kienbock’s Disease. The patients were randomized to either open scaphocapitate fusion with or without lunate revascularization (Group I) or arthroscopic scaphocapitate fusion with capitate pole excision (Group II).
Follow-up was at an average of 33 months. While there was no statistically significant difference between the groups, both groups demonstrated a significant increase in grip strength and range of motion at final follow-up.
The authors suggest that revascularization of the lunate should be performed with an adjunctive decompression of the lunate. Decompression may be accomplished by scaphocapitate arthrodesis with an associated proximal pole resection. Whether the decompression is performed open or arthroscopically does not appear to make a difference, at least in the numbers the authors have put forth.
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Arthroscopy