{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:32:52Z","timestamp":1790839972876,"version":"4.1.0"},"reference-count":77,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Kienb\u00f6ck\u2019s disease is a rare disease described as progressive avascular osteonecrosis of the lunate. The typical manifestations include a unilateral reduction in wrist motion with accompanying pain and swelling. Besides recent advances in treatment options, the etiology and pathophysiology of the disease remain poorly understood. Common risk factors include anatomical features including ulnar variance, differences in blood supply, increased intraosseous pressure along with direct trauma, and environmental influence. The staging of Kienb\u00f6ck\u2019s disease depends mainly on radiographic characteristics assessed according to the modified Lichtman scale. The selection of treatment options is often challenging, as radiographic features may not correspond directly to initial clinical symptoms and differ among age groups. At the earliest stages of Kienb\u00f6ck disease, the nonoperative, unloading management is generally preferred. Patients with negative ulnar variance are usually treated with radial shortening osteotomy. For patients with positive or neutral ulnar variance, a capitate shortening osteotomy is a recommended option. One of the most recent surgical techniques used in Stage III Kienb\u00f6ck cases is vascularized bone grafting. One of the most promising procedures is a vascularized, pedicled, scaphoid graft combined with partial radioscaphoid arthrodesis. This technique provides excellent pain management and prevents carpal collapse. In stage IV, salvage procedures including total wrist fusion or total wrist arthroplasty are often required.<\/jats:p>","DOI":"10.3390\/jcm11030664","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T22:00:56Z","timestamp":1643320856000},"page":"664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Recent Advances in Assessment and Treatment in Kienb\u00f6ck\u2019s Disease"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0317-5223","authenticated-orcid":false,"given":"Karol","family":"Chojnowski","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3423-3745","authenticated-orcid":false,"given":"Miko\u0142aj","family":"Opie\u0142ka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4464-816X","authenticated-orcid":false,"given":"Mi\u0142osz","family":"Piotrowicz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-9701","authenticated-orcid":false,"given":"Bartosz Kamil","family":"Sobocki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5328-054X","authenticated-orcid":false,"given":"Justyna","family":"Napora","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"D\u0105browski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Piotrowski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Mazurek","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University of Gdansk, 80-803 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jhsa.2007.11.005","article-title":"Long-term subjective and radiological outcome after reconstruction of Kienb\u00f6ck\u2019s disease stage 3 treated by a free vascularized iliac bone graft","volume":"33","author":"Arora","year":"2008","journal-title":"J. Hand Surg. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.main.2014.10.149","article-title":"Kienb\u00f6ck\u2019s disease","volume":"34","author":"Fontaine","year":"2015","journal-title":"Chir. Main"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.main.2013.07.010","article-title":"Graner\u2019s procedure in Kienb\u00f6ck disease: A series of four cases with 25 years of follow-up","volume":"32","author":"Facca","year":"2013","journal-title":"Chir. Main"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1007\/s11999-015-4541-1","article-title":"What Is the Radiographic Prevalence of Incidental Kienb\u00f6ck Disease?","volume":"474","author":"Janssen","year":"2016","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00256-016-2332-8","article-title":"Treatments for Kienb\u00f6ck disease: What the radiologist needs to know","volume":"45","author":"White","year":"2016","journal-title":"Skeletal Radiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/BTH.0b013e3182107329","article-title":"Etiology of Kienb\u00f6ck disease","volume":"15","author":"Lluch","year":"2011","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/2468-6360.198799","article-title":"Surgical interventions for Kienbock\u2019s disease: An update","volume":"5","author":"Alsanawi","year":"2017","journal-title":"J. Health Spec."},{"key":"ref_8","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","journal-title":"J. Hand Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00130911-200603000-00003","article-title":"Arthroscopic assessment and classification of Kienbock\u2019s disease","volume":"10","author":"Bain","year":"2006","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/BTH.0b013e31820e82e8","article-title":"An articular-based approach to Kienbock avascular necrosis of the lunate","volume":"15","author":"Bain","year":"2011","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S0720-048X(97)00065-X","article-title":"Imaging and staging of avascular osteonecroses at the wrist and hand","volume":"25","author":"Schmitt","year":"1997","journal-title":"Eur. J. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1097\/CORR.0000000000000595","article-title":"In Brief: The Lichtman Classification for Kienb\u00f6ck Disease","volume":"477","author":"Kennedy","year":"2019","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_13","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."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1055\/s-0036-1593734","article-title":"Kienb\u00f6ck disease: A new algorithm for the 21st century","volume":"6","author":"Lichtman","year":"2017","journal-title":"J. Wrist Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/PRS.0000000000007838","article-title":"Functional and radiographic disease progression in nonoperatively managed Kienb\u00f6ck disease","volume":"147","author":"DeGeorge","year":"2021","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_16","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."},{"key":"ref_17","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 Jt. Surg. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S0363-5023(97)80003-2","article-title":"Radial recession osteotomy for Kienb\u00f6ck\u2019s disease","volume":"22","author":"Quenzer","year":"1997","journal-title":"J. Hand Surg. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.jhsa.2005.03.019","article-title":"Vascularized os pisiform for reinforcement of the lunate in Kienb\u00f6ck\u2019s disease: An average of 12 years of follow-up study","volume":"30","author":"Daecke","year":"2005","journal-title":"J. Hand Surg. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.3109\/17453676808989471","article-title":"Kienboeck\u2019s disease treated with osteotomy to lengthen ulna","volume":"39","author":"Tillberg","year":"1968","journal-title":"Acta Orthop. Scand."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0266-7681(96)80092-1","article-title":"Ulnar lengthening and radial recession procedures for Kienb\u00f6ck\u2019s disease. Long-term clinical and radiographic follow-up","volume":"21","author":"Trail","year":"1996","journal-title":"J. Hand Surg. Br."},{"key":"ref_22","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."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1016\/j.injury.2020.02.036","article-title":"Experimental shortening of the radius in the treatment of Kienb\u00f6ck\u2019s disease","volume":"52","author":"Kopljar","year":"2021","journal-title":"Injury"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1558944715616953","article-title":"Current trends in treatment of Kienb\u00f6ck disease: A survey of hand surgeons","volume":"11","author":"Kolovich","year":"2016","journal-title":"Hand"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1142\/S2424835521400038","article-title":"Kienbock\u2019s disease: Treatment options\u2014A search for the apt!","volume":"26","author":"Bhardwaj","year":"2021","journal-title":"J. Hand Surg. Asian-Pac. Vol."},{"key":"ref_26","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 Surg. Br."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1097\/PRS.0b013e3181addc50","article-title":"Isolated capitate shortening osteotomy for the early stage of Kienb\u00f6ck disease with neutral ulnar variance","volume":"124","author":"Gay","year":"2009","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/BTH.0b013e3181e1d2b4","article-title":"Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate","volume":"15","author":"Bain","year":"2011","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1016\/j.jhsa.2011.06.024","article-title":"Treatment of Kienb\u00f6ck disease by lunate core decompression","volume":"36","author":"Mehrpour","year":"2011","journal-title":"J. Hand Surg. Am."},{"key":"ref_30","unstructured":"Kamrani, R.S., Najafi, E., Azizi, H., and Oryadi Zanjani, L. (2021). Outcomes of arthroscopic lunate core decompression versus radial osteotomy in treatment of Kienb\u00f6ck disease. J. Hand Surg. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1142\/S2424835519500346","article-title":"Metaphyseal core decompression of the distal radius for early lunate necrosis","volume":"24","author":"Schulz","year":"2019","journal-title":"J. Hand Surg. Asian Pac. Vol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1053\/jhsu.2001.22928","article-title":"The surgical treatment of Kienb\u00f6ck\u2019s disease by radius and ulna metaphyseal core decompression","volume":"26","author":"Illarramendi","year":"2001","journal-title":"J. Hand Surg. Am."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/00130911-200309000-00007","article-title":"Radius decompression for treatment of kienb\u00f6ck disease","volume":"7","author":"Illarramendi","year":"2003","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_34","first-page":"5557","article-title":"Midterm results of radial metaphyseal core decompression on Kienb\u00f6ck\u2019s disease","volume":"21","author":"Sevimli","year":"2017","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/0266-7681(94)90212-7","article-title":"Kienb\u00f6ck\u2019s disease, early stage 3\u2014Height reconstruction and core revascularization of the lunate","volume":"19","author":"Bochud","year":"1994","journal-title":"J. Hand Surg. Br."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jhsa.2004.10.002","article-title":"The use of the 4 + 5 extensor compartmental vascularized bone graft for the treatment of Kienb\u00f6ck\u2019s disease","volume":"30","author":"Moran","year":"2005","journal-title":"J. Hand Surg. Am."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1055\/s-0036-1582427","article-title":"Vascularized bone grafts from the dorsal wrist for the treatment of Kienb\u00f6ck disease","volume":"5","author":"Nakagawa","year":"2016","journal-title":"J. Wrist Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1055\/s-0038-1677318","article-title":"The efficacy of vascularized bone grafts in the treatment of scaphoid nonunions and kienbock disease: A systematic review in 917 Patients","volume":"11","author":"Tsantes","year":"2019","journal-title":"J. Hand Microsurg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s00132-018-3641-5","article-title":"Kienb\u00f6ck\u2019s disease with non-negative ulnar variance: Treatment with combined radial wedge and shortening osteotomy","volume":"48","author":"Hong","year":"2019","journal-title":"Orthopade"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"752.e1","DOI":"10.1016\/j.jhsa.2017.05.017","article-title":"Radius core decompression for Kienb\u00f6ck disease stage IIIA: Outcomes at 13 years follow-up","volume":"42","author":"Zaidenberg","year":"2017","journal-title":"J. Hand Surg. Am."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1055\/s-0034-1372484","article-title":"Osteochondral flaps from the distal femur: Expanding applications, harvest sites, and indications","volume":"30","author":"Higgins","year":"2014","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0363-5023(85)80101-5","article-title":"An approach to Kienb\u00f6ck\u2019s disease: Triscaphe arthrodesis","volume":"10","author":"Watson","year":"1985","journal-title":"J. Hand Surg. Am."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1142\/S021881040900427X","article-title":"Radioscapholunate arthrodesis\u2014A prospective study","volume":"14","author":"Bain","year":"2009","journal-title":"Hand Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/j.jhsa.2008.02.031","article-title":"Proximal row carpectomy for advanced Kienb\u00f6ck\u2019s disease: Average 10-year follow-up","volume":"33","author":"Croog","year":"2008","journal-title":"J. Hand Surg. Am."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s11552-011-9368-y","article-title":"Long-term outcomes of proximal row carpectomy: A minimum of 15-year follow-up","volume":"7","author":"Ali","year":"2012","journal-title":"Hand"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1007\/s00264-009-0770-9","article-title":"Clinical evaluation of proximal row carpectomy revealed by follow-up for 10\u201329 years","volume":"33","author":"Liu","year":"2009","journal-title":"Int. Orthop."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/01.sap.0000235425.03914.4f","article-title":"Vascularized capitate transposition for advanced Kienb\u00f6ck disease: Application of 40 cases and their anatomy","volume":"57","author":"Lu","year":"2006","journal-title":"Ann. Plast. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1177\/1753193418780552","article-title":"Capitate osteotomy and transposition for type III Kienb\u00f6ck\u2019s disease","volume":"43","author":"Li","year":"2018","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_49","first-page":"230","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. Off. J. Jpn. Orthop. Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/J.JHSB.2004.11.008","article-title":"Total wrist fusion: A study of 115 patients","volume":"30","author":"Rauhaniemi","year":"2005","journal-title":"J. Hand Surg. Am."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/S0363-5023(96)80147-X","article-title":"Proximal row carpectomy with partial capitate resection","volume":"21","author":"Salomon","year":"1996","journal-title":"J. Hand Surg. Am."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.jhsa.2005.12.012","article-title":"Long-term follow-up evaluation of denervation of the wrist","volume":"31","author":"Schweizer","year":"2006","journal-title":"J. Hand Surg. Am."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/S0363-5023(05)80457-5","article-title":"Temporary internal fixation of the scaphotrapezio-trapezoidal joint for the treatment of kienbock\u2019s disease: A preliminary study","volume":"23","author":"Yajima","year":"1998","journal-title":"J. Hand Surg. Am."},{"key":"ref_54","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. A retrospective study","volume":"25","author":"Dury","year":"2006","journal-title":"Chir. Main"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/0363-5023(90)90051-R","article-title":"Scapho-trapezio-trapezoid arthrodesis for treatment of chronic static and dynamic scapho-lunate instability: A 10-year perspective on pitfalls and complications","volume":"15","author":"Kleinman","year":"1990","journal-title":"J. Hand Surg. Am."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1016\/j.jhsa.2015.04.033","article-title":"Proximal row carpectomy","volume":"40","author":"Green","year":"2015","journal-title":"J. Hand Surg. Am."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1051\/sicotj\/2015026","article-title":"Does dorsal capsule interposition improve the results of proximal row carpectomy in Kienb\u00f6ck\u2019s disease? One year randomized trial","volume":"1","author":"Fukushima","year":"2015","journal-title":"SICOT-J"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1055\/s-0032-1323643","article-title":"Proximal row carpectomy combined with wrist hemiarthroplasty","volume":"1","author":"Culp","year":"2012","journal-title":"J. Wrist Surg."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/BTH.0b013e31827f452a","article-title":"New surgical approach to advanced Kienb\u00f6ck disease: Lunate replacement with pedicled vascularized scaphoid graft and radioscaphoidal partial arthrodesis","volume":"17","author":"Mir","year":"2013","journal-title":"Tech. Hand Up. Extrem. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e13229","DOI":"10.1097\/MD.0000000000013229","article-title":"Long-term results of vascularized os pisiform transfer for advanced Kienb\u00f6ck disease after follow-up for at least 15 years A case series","volume":"97","author":"Tan","year":"2018","journal-title":"Medicine"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"773.e1","DOI":"10.1016\/j.jhsa.2018.01.008","article-title":"Vascularized bone graft to the lunate combined With temporary scaphocapitate fixation for treatment of stage III Kienb\u00f6ck disease: A report of the results, a minimum of 2 years after surgery","volume":"43","author":"Matsumoto","year":"2018","journal-title":"J. Hand Surg. Am."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"210","DOI":"10.5435\/00124635-200205000-00007","article-title":"Pedicled vascularized bone grafts for disorders of the carpus: Scaphoid nonunion and Kienbock\u2019s disease","volume":"10","author":"Shin","year":"2002","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/0363-5023(91)90017-6","article-title":"A new vascularized bone graft for scaphoid nonunion","volume":"16","author":"Zaidemberg","year":"1991","journal-title":"J. Hand Surg. Am."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/BF01794937","article-title":"Anatomical bases of the pediculated pisiform transplant and the intercarpal fusion by graner in Kienb\u00f6ck\u2019s disease","volume":"14","author":"Heymans","year":"1992","journal-title":"Surg. Radiol. Anat."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1053\/jhsu.2000.5993","article-title":"Free vascularized bone graft for nonunion of the scaphoid","volume":"25","author":"Doi","year":"2000","journal-title":"J. Hand Surg. Am."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1002\/micr.1920150505","article-title":"Vascularized periosteal bone graft from the supracondylar region of the femur","volume":"15","author":"Doi","year":"1994","journal-title":"Microsurgery"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1142\/S0218810415400079","article-title":"Kienb\u00f6ck Disease: Recent advances in the basic science, assessment and treatment","volume":"20","author":"Bain","year":"2015","journal-title":"Hand Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.jhsa.2013.02.010","article-title":"Long-term results of vascularized bone graft for stage III Kienb\u00f6ck disease","volume":"38","author":"Fujiwara","year":"2013","journal-title":"J. Hand Surg. Am."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/1753193419886724","article-title":"Bone marrow from the iliac crest versus from the distal radius for revitalizing the necrotic lunate for Kienb\u00f6ck disease","volume":"45","author":"Ogawa","year":"2020","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2226","DOI":"10.1016\/j.jhsa.2012.08.031","article-title":"Scaphotrapeziotrapezoid arthrodesis and lunate excision for advanced kienb\u00f6ck disease","volume":"37","author":"Lee","year":"2012","journal-title":"J. Hand Surg. Am."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"945.e1","DOI":"10.1016\/j.jhsa.2018.02.009","article-title":"Long-term clinical outcome after titanium lunate arthroplasty for Kienb\u00f6ck disease","volume":"43","author":"Viljakka","year":"2018","journal-title":"J. Hand Surg. Am."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s00402-017-2854-0","article-title":"3D printing lunate prosthesis for stage IIIc Kienb\u00f6ck\u2019s disease: A case report","volume":"138","author":"Xie","year":"2018","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/os.12681","article-title":"Varisized 3D-printed lunate for Kienb\u00f6ck\u2019s disease in different stages: Preliminary results","volume":"12","author":"Ma","year":"2020","journal-title":"Orthop. Surg."},{"key":"ref_74","first-page":"e1387","article-title":"Arthroscopic lunate excision provides excellent outcomes for low-demand patients with advanced Kienb\u00f6ck disease","volume":"3","author":"Shimizu","year":"2021","journal-title":"Arthrosc. Sport. Med. Rehabil."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1055\/s-0040-1722570","article-title":"Arthroscopic debridement and arthrolysis for the treatment of advanced Kienb\u00f6ck\u2019s dsease: 18-month and 5-year postoperative results","volume":"10","author":"Ayik","year":"2021","journal-title":"J. Wrist Surg"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jhsa.2008.09.019","article-title":"Temporary scaphotrapezoidal joint fixation for adolescent Kienb\u00f6ck\u2019s disease","volume":"34","author":"Ando","year":"2009","journal-title":"J. Hand Surg. Am."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.jos.2017.02.002","article-title":"A clinical trial for Kienb\u00f6ck disease by cultured autologous multipotent mesenchymal stromal cells augmented with vascularized bone grafts: A report of five cases","volume":"24","author":"Ikeguchi","year":"2019","journal-title":"J. Orthop. 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