{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:01:09Z","timestamp":1791756069534,"version":"4.3.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Currently Kienb\u00f6ck\u2019s disease remains an \u2018unsolved\u2019 problem in hand surgery. Different factors have been associated with the avascular necrosis of the lunate. Mechanical, vascular and biological factors, alone or in combination, may have an influence in the aetiopathogenesis and determine the progress of the disease and even the results of the treatment. This is especially relevant in the early stages, in which conservative or surgical treatment may modify the natural history of the disease, maintaining the lunate structure and thus preserving the joint surfaces. There are multiple surgical treatments for Kienb\u00f6ck\u2019s disease in the early stages, before lunate collapse; each one is based on one of the possible factors that can cause avascular necrosis of the lunate. The objective is not only to treat symptoms but to prevent progression. This article is a review of the most frequent treatments used in the early stages and a personal view of the authors.<\/jats:p>\n                  <jats:p>Level of evidence: V<\/jats:p>","DOI":"10.1177\/17531934221146851","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T05:31:42Z","timestamp":1676611902000},"page":"246-256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Kienb\u00f6ck\u2019s disease: preventing disease progression in early-stage disease"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-0718","authenticated-orcid":false,"given":"Guillem","family":"Salva-Coll","sequence":"first","affiliation":[{"name":"Hand and Upper Extremity Surgery, Kaplan Institute, Barcelona, Spain"},{"name":"Department of Hand Surgery and Microsurgery, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain"},{"name":"Ibacma Institute, Balearic Institute for Hand Surgery, Palma de Mallorca, Illes Balears, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Esplugas","sequence":"additional","affiliation":[{"name":"Hand and Upper Extremity Surgery, Kaplan Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Carre\u00f1o","sequence":"additional","affiliation":[{"name":"Hand and Upper Extremity Surgery, Kaplan Institute, Barcelona, Spain"},{"name":"Hand and Elbow Surgery, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Lluch-Bergada","sequence":"additional","affiliation":[{"name":"Hand and Upper Extremity Surgery, Kaplan Institute, Barcelona, Spain"},{"name":"Department of Hand and Upper Extremity Surgery, Hospital Vall d\u2019Hebron, Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"bibr1-17531934221146851","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198601000-00009"},{"key":"bibr2-17531934221146851","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0712(21)01265-8"},{"key":"bibr3-17531934221146851","first-page":"100","volume":"37","author":"Antu\u00f1a Zapico J.","year":"1993","journal-title":"Rev Ortop Traumatol"},{"key":"bibr4a-17531934221146851","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90116-3"},{"key":"bibr4-17531934221146851","doi-asserted-by":"publisher","DOI":"10.1097\/00130911-200603000-00003"},{"key":"bibr5-17531934221146851","doi-asserted-by":"crossref","unstructured":"Bain GI, MacLean SB, Yeo CJ, Perilli E, Lichtman DM. 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