{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:59:27Z","timestamp":1788962367047,"version":"build-2803163510"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,7]]},"abstract":"<jats:p>Kienb\u00f6ck\u2019s disease is a rare condition characterised by avascular necrosis of the lunate bone. Its natural history and aetiopathogenesis have not yet been clarified, nor are its triggering factors identified. We present a case of a 17-year-old male gymnast, without relevant medical\/family history, with stage IIIA Kienb\u00f6ck\u2019s disease diagnosed in 2016. Initially, submitted to conservative treatment that proved to be insufficient. Consequently, surgical treatment was proposed, but refused. The patient instead underwent experimental treatment with hyperbaric oxygen (120 sessions, 100% oxygen at 2.5 atm, for 70\u2009min periods, once daily, five times per week). In April 2018, a favourable clinical and radiological evolution was observed, with an improvement in the patterns of pain, motion and strength and an almost complete involution of the process of aseptic necrosis of the semilunar. To the best of our knowledge, this is the first report of Kienb\u00f6ck\u2019s disease treated with hyperbaric oxygen.<\/jats:p>","DOI":"10.1136\/bcr-2018-226090","type":"journal-article","created":{"date-parts":[[2018,10,13]],"date-time":"2018-10-13T01:45:27Z","timestamp":1539395127000},"page":"bcr-2018-226090","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Stage III Kienb\u00f6ck\u2019s disease treated with hyperbaric oxygen: the role of an unusual approach to a rare condition"],"prefix":"10.1136","volume":"2018","author":[{"given":"Paulo Jorge","family":"Figueira","sequence":"first","affiliation":[{"name":"Orthopaedic Department, Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, Lisbon, Portugal"},{"name":"Centro de Medicina Naval, Marinha Portuguesa, Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo","family":"Alpuim Costa","sequence":"additional","affiliation":[{"name":"Haematology and Oncology Department, Instituto CUF de Oncologia (I.C.O.), Lisbon, Portugal"},{"name":"Centro de Medicina Subaqu\u00e1tica e Hiperb\u00e1rica, Marinha Portuguesa, Marinha Portuguesa, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nunzio","family":"Barbagallo","sequence":"additional","affiliation":[{"name":"Physics and Astronomy Department, Universit\u00e0 di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Gamito","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"Centro de Medicina Subaqu\u00e1tica e Hiperb\u00e1rica, Marinha Portuguesa, Marinha Portuguesa, Lisbon, Portugal"},{"name":"Centro de Investiga\u00e7\u00e3o Naval (CINAV), Marinha Portuguesa, Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,12]]},"reference":[{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193410373703"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2006.07.003"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.3","first-page":"275","article-title":"Kienbock\u2019s disease in a varsity football player: a case report and review of the literature","volume":"56","author":"Laframboise","year":"2012","journal-title":"J Can Chiropr Assoc"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(83)80195-6"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.5","doi-asserted-by":"crossref","first-page":"1185.e5","DOI":"10.1016\/j.ajem.2015.11.036","article-title":"Avascular necrosis of lunate bone: Kienbock disease","volume":"34","author":"Salt","year":"2016","journal-title":"Am J Emerg Med"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(79)80101-X"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.7","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s00776-012-0332-7","article-title":"A new treatment strategy for Kienb\u00f6ck\u2019s disease: combination of bone marrow transfusion, low-intensity pulsed ultrasound therapy, and external fixation","volume":"18","author":"Ogawa","year":"2013","journal-title":"J Orthop Sci"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.8","first-page":"323","article-title":"Medicina hiperb\u00e1rica","volume":"22","author":"Fernandes","year":"2009","journal-title":"Acta Med Port"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.9","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B3.13237"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2010.00660.x"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.11","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.91054.2008"},{"key":"2025082802303007000_2018.oct12_1.bcr-2018-226090.12","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.scr.2014.02.005","article-title":"CD34+\/CD45-dim stem cell mobilization by hyperbaric oxygen - 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