{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:40:54Z","timestamp":1788406854104,"version":"build-2803163510"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,7,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radial osteotomy has shown favorable clinical results for early to advanced stages of Kienb\u00f6ck disease. However, it is not clear whether this technique could change the natural course of the disease, or whether its clinical results are actually superior to those of nonoperative treatment. The purpose of this study was to compare radial osteotomy with nonoperative treatment in terms of long-term radiographic and clinical outcomes in patients with Kienb\u00f6ck disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We systematically reviewed retrospective studies of radial osteotomy and nonoperative treatment for Kienb\u00f6ck disease with long-term follow-up (mean of \u226510 years). A systematic search was conducted across 3 databases (CENTRAL, PubMed, and Embase) and relevant articles were selected. Data regarding patient demographics, treatment details, and radiographic and clinical outcomes were abstracted from the selected studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventeen studies (5 of nonoperative treatment and 12 of radial osteotomy) were included. Before treatment, the mean age of patients and mean proportion of wrists with Lichtman stage III or higher were not significantly different between the 2 groups. Neither the mean proportion of wrists that showed worsening of the Lichtman stage after treatment nor the proportion that showed no change in the stage were significantly different between the 2 groups. However, the mean proportion of wrists that had more than moderate pain at the time of final follow-up was significantly lower in the radial osteotomy group (5.7%; range, 0% to 18.2%) than in the nonoperative treatment group (23.2%; range, 17.4% to 35.3%). In addition, the total arc of wrist motion at the time of final follow-up was significantly greater in the radial osteotomy group (107.4\u00b0 \u00b1 10.0\u00b0; range, 93.0\u00b0 to 126.0\u00b0) than in the nonoperative treatment group (88.8\u00b0 \u00b1 13.2\u00b0; range, 68.5\u00b0 to 103.5\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Systematic review of long-term follow-up studies showed that radial osteotomy was not superior to nonoperative treatment in terms of disease progression according to the Lichtman stage. Nevertheless, radial osteotomy was reported to have better outcomes with respect to the extent of pain and range of wrist motion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00764","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T16:21:19Z","timestamp":1532017279000},"page":"1231-1240","source":"Crossref","is-referenced-by-count":26,"title":["Comparison of Long-Term Outcomes of Radial Osteotomy and Nonoperative Treatment for Kienb\u00f6ck Disease"],"prefix":"10.2106","volume":"100","author":[{"given":"Young Ho","family":"Shin","sequence":"first","affiliation":[{"name":"Departments of Orthopedic Surgery (Y.H.S., J.K.K., T.K.L., and J.O.Y.) and Clinical Epidemiology and Biostatistics (M.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-4634","authenticated-orcid":false,"given":"Jae Kwang","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery (Y.H.S., J.K.K., T.K.L., and J.O.Y.) and Clinical Epidemiology and Biostatistics (M.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minkyu","family":"Han","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery (Y.H.S., J.K.K., T.K.L., and J.O.Y.) and Clinical Epidemiology and Biostatistics (M.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Kyoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery (Y.H.S., J.K.K., T.K.L., and J.O.Y.) and Clinical Epidemiology and Biostatistics (M.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun O","family":"Yoon","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery (Y.H.S., J.K.K., T.K.L., and J.O.Y.) and Clinical Epidemiology and Biostatistics (M.H.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,7,18]]},"reference":[{"issue":"5","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.jhsa.2010.02.002","article-title":"Systematic review of the treatment of Kienb\u00f6ck\u2019s disease in its early and late stages","volume":"35","author":"Innes","year":"2010","journal-title":"J Hand Surg Am."},{"issue":"2","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"128","DOI":"10.5435\/00124635-200103000-00006","article-title":"Kienbock\u2019s disease: diagnosis and treatment","volume":"9","author":"Allan","year":"2001","journal-title":"J Am Acad Orthop Surg."},{"issue":"2","key":"bib3-20230810","first-page":"65","article-title":"[Kienbock\u2019s disease in miners; clinical & pathogenic study with analysis of 1330 x-rays of the wrist]","volume":"12","author":"Decoulx","year":"1957","journal-title":"Lille Chir."},{"issue":"7","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/1753193410374690","article-title":"The classification and treatment of Kienbock\u2019s disease: the state of the art and a look at the future","volume":"35","author":"Lichtman","year":"2010","journal-title":"J Hand Surg Eur Vol."},{"issue":"1","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jhsa.2008.10.012","article-title":"Kienb\u00f6ck\u2019s disease","volume":"34","author":"Beredjiklian","year":"2009 Jan","journal-title":"J Hand Surg Am."},{"issue":"1","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1055\/s-0035-1544225","article-title":"The management of Kienb\u00f6ck disease: a survey of the ASSH membership","volume":"4","author":"Danoff","year":"2015","journal-title":"J Wrist Surg."},{"issue":"2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/1457496915577023","article-title":"Long-term natural outcome (7-26 years) of Lichtman stage III Kienbock\u2019s lunatomalacia","volume":"105","author":"Viljakka","year":"2016","journal-title":"Scand J Surg."},{"issue":"3-4","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.main.2006.07.030","article-title":"Conservative treatment versus scaphotrapeziotrapezoid arthrodesis for Kienbock\u2019s disease. 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disease","volume":"5","author":"Tatebe","year":"2016","journal-title":"J Wrist Surg."},{"issue":"7","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/1753193413512222","article-title":"Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienb\u00f6ck\u2019s lunatomalacia","volume":"39","author":"Viljakka","year":"2014","journal-title":"J Hand Surg Eur Vol."},{"issue":"4","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jhsa.2014.01.020","article-title":"Radial shortening osteotomy for Kienb\u00f6ck disease: minimum 10-year follow-up","volume":"39","author":"Matsui","year":"2014","journal-title":"J Hand Surg Am."},{"issue":"4","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1097\/BTH.0b013e31826d2f77","article-title":"Radial shortening osteotomy in advanced stages of Kienbock disease","volume":"16","author":"Mozaffarian","year":"2012","journal-title":"Tech Hand Up Extrem Surg."},{"issue":"11","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1016\/j.jhsa.2012.07.023","article-title":"Osteotomy of the radius without shortening for Kienb\u00f6ck disease: a 10-year follow-up","volume":"37","author":"Blanco","year":"2012","journal-title":"J Hand Surg Am."},{"issue":"8","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.2106\/JBJS.G.00421","article-title":"Long-term follow-up of radial shortening osteotomy for Kienbock disease","volume":"90","author":"Watanabe","year":"2008","journal-title":"J Bone Joint Surg Am."},{"key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/BLO.0b013e318041d309","article-title":"Outcome of Kienb\u00f6ck\u2019s disease 22 years after distal radius shortening osteotomy","volume":"460","author":"Raven","year":"2007","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/J.JHSB.2004.12.008","article-title":"Long-term outcome of radial shortening with or without ulnar shortening for treatment of Kienbock\u2019s disease: a 13-25 year follow-up","volume":"30","author":"Zenzai","year":"2005","journal-title":"J Hand Surg Br."},{"issue":"6","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/S0363-5023(03)00490-8","article-title":"Surgical outcome of radial osteotomy for Kienb\u00f6ck\u2019s disease-minimum 10 years of follow-up","volume":"28","author":"Koh","year":"2003","journal-title":"J Hand Surg Am."},{"issue":"2","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1054\/JHSB.2001.0621","article-title":"Radial closing wedge osteotomy for Kienb\u00f6ck\u2019s disease: an over 10 year clinical and radiographic follow-up","volume":"27","author":"Wada","year":"2002","journal-title":"J Hand 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Br."},{"issue":"3","key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/BF02349816","article-title":"Long-term follow up of patients with conservatively treated Kienb\u00f6ck\u2019s disease","volume":"1","author":"Fujisawa","year":"1996","journal-title":"J Orthop Sci."},{"issue":"3","key":"bib29-20230810","first-page":"422","article-title":"Kienb\u00f6ck\u2019s disease\u2014late results by non-surgical treatment. A follow-up study","volume":"11","author":"Kristensen","year":"1986","journal-title":"J Hand Surg Br."},{"issue":"3","key":"bib30-20230810","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.jhsa.2009.12.003","article-title":"Publication bias in Kienb\u00f6ck\u2019s disease: systematic review","volume":"35","author":"Squitieri","year":"2010","journal-title":"J Hand Surg Am."},{"issue":"9","key":"bib31-20230810","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.2106\/00004623-199173090-00015","article-title":"Radial wedge osteotomy for Kienb\u00f6ck disease","volume":"73","author":"Nakamura","year":"1991","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib32-20230810","doi-asserted-by":"crossref","first-page":"384","DOI":"10.2106\/00004623-199173030-00009","article-title":"Radial shortening for Kienb\u00f6ck disease","volume":"73","author":"Weiss","year":"1991","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib33-20230810","first-page":"283","article-title":"Lateral closing wedge osteotomy for treatment of Kienb\u00f6ck\u2019s disease. A clinical and biomechanical study of the optimum correcting angle","volume":"17","author":"Garcia-Elias","year":"1998","journal-title":"Chir Main."},{"issue":"1","key":"bib34-20230810","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0363-5023(86)80111-3","article-title":"A biomechanical comparison of the methods for treating Kienb\u00f6ck\u2019s disease","volume":"11","author":"Trumble","year":"1986","journal-title":"J Hand Surg Am."},{"issue":"6","key":"bib35-20230810","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S0266-7681(98)80087-9","article-title":"Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienb\u00f6ck\u2019s disease","volume":"23","author":"Nakamura","year":"1998","journal-title":"J Hand Surg Br."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201807180-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:41:37Z","timestamp":1787751697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201807180-00010"}},"subtitle":["A Systematic Review"],"short-title":[],"issued":{"date-parts":[[2018,7,18]]},"references-count":34,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.00764","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,18]]}}}