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Many previously known risk factors for other avascular necrosis were found to be associated with Kienb\u00f6ck\u2019s disease, such as alcohol abuse (odds ratio (OR) 1.67), rheumatic diseases (OR 1.81), coagulopathic state (OR 1.59) and history of hand and wrist injuries (OR 3.03). Operated patients had a higher prevalence of type 1 diabetes (OR 2.43) and coagulopathic risk factors (OR 1.40). Patients requiring total wrist arthrodesis had a higher prevalence of immunosuppression (OR 1.77), cardiovascular risk factors (OR 2.31), alcohol abuse (OR 2.13), rheumatoid arthritis (OR 3.74), pancreatitis (OR 3.03) and hypertension (OR 1.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Many systemic disorders were found to be associated with Kienb\u00f6ck\u2019s disease. Wrist and hand injuries might also be predisposing factors. Factors such as immunosuppression, alcohol abuse and cardiovascular risk factors may increase the risk of developing a more severe form of this disease, requiring surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>III<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17531934251387061","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T08:58:50Z","timestamp":1761814730000},"page":"415-421","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for Kienb\u00f6ck\u2019s disease and need for surgical intervention: a nationwide register study from Finland"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1899-3891","authenticated-orcid":false,"given":"Krista","family":"Wern\u00e9r","sequence":"first","affiliation":[{"name":"Musculoskeletal and Plastic Surgery, Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turkka","family":"Anttila","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Plastic Surgery, Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Viljakka","sequence":"additional","affiliation":[{"name":"Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma","family":"Ryh\u00e4nen","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Plastic Surgery, Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Hulkkonen","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Plastic Surgery, Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1583755"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000002735"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.218.2.r01fe03411"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103161"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-233725"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200111000-00004"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e65"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2021.116215"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-012-9477-2"},{"key":"e_1_3_3_11_1","first-page":"8","article-title":"Kienbock\u2019s disease and juvenile idiopathic arthritis","volume":"13","author":"Desy NM","year":"2011","unstructured":"Desy NM, Bernstein M, Harvey EJ, Hazel H. 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