Publication:

Evaluation of clinico-radiological outcomes in the treatment of Lichtman stage upto IIIa Kienböck’s disease by radius core decompression

Background Kienböck’s disease is a progressive osteonecrosis of the lunate leading to chronic wrist pain and dysfunction. Radius core decompression (RCD) is a joint-preserving, minimally invasive procedure that aims to improve lunate perfusion by reducing intraosseous pressure. This study evaluates the clinico-radiological outcomes of RCD in patients with Lichtman stage I–IIIa disease.

Methods A prospective observational study was conducted at the Department of Orthopaedics, SMS Medical College, Jaipur, including 32 patients with Lichtman stage I–IIIa Kienböck’s disease. All patients underwent RCD and were followed for a mean of 16.7 months. Functional outcomes were assessed using the visual analogue scale (VAS), grip strength, and wrist range of motion. Radiological evaluation was done using the modified carpal height ratio (MCHR).

Results The mean VAS score improved from 7.08 preoperatively to 3.31 postoperatively (p<0.001). Mean grip strength increased from 57.03% to 60.02% of the contralateral hand (p<0.001). There was significant improvement in wrist range of motion, including palmar flexion, dorsiflexion, and ulnar deviation. The mean MCHR stabilized postoperatively (1.55±0.016), indicating maintenance of carpal height. No cases progressed to advanced disease during follow-up.

Conclusions Radius core decompression is a safe and effective joint-preserving technique for early-stage Kienböck’s disease, providing significant pain relief, functional improvement, and stabilization of radiological parameters. It offers a viable alternative to more invasive revascularization or joint-leveling procedures in Lichtman stage I–IIIa disease.