Efficiency of concentrated bone marrow aspirate combination with temporary fixation of the scaphoid-trapezius-trapezoidal joint in Kienbeck’s disease

Authors

  • м Tymochenko  SI «Institute of traumatology and orthopedics of National Academy of Medical Sciences of Ukraine», Kyiv, Ukraine
  • Igor Gajovich SI «Institute of Traumatology and Orthopaedics of the NAMS of Ukraine», Kyiv, Ukraine
  • Sаmir Аbbasov «Center of Scientific Surgery named after Academician Topchubashov», Baku. Azerbaijan, Azerbaijan
  • Аndrij Lysak SI «Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine», Kyiv , Ukraine

DOI:

https://doi.org/10.15674/0030-59872020443-48

Keywords:

Bone marrow aspirate concentrate, lunate bone, radiography, joint instability, bone remodeling, osteonecrosis

Abstract

Method of concentrated bone marrow aspirate (BMAC) injection into aseptic bone necrosis of different localizations are described in the literature, however, without demonstrating structural and functional results for Kienbeck’s disease. Objective. To establish functional and radiological changes at injection of concentrated bone marrow aspirate into lunate bone in combination with scaphoid-trapezoid-trapezius joint temporary fixation in patients with idiopathic lunate bone necrosis. Methods. The procedure was performed in 11 patients. Age 18–46 years (28,9 ± 9,5) 6 women, 5 males. Kienbeck's disease stage II — 4 patients, IIIa — in 2, IIIb in 5 patients. Bone marrow aspirate concentration from the ili­ac bone was obtained using Arthrex-Angel technique, injection of 2–3 ml of the concentrate with intraosseous needle under X-ray control into the focus of aseptic necrosis of the lunate bone, STT-fixation of the wrist joint in the position of rotational correction of the scaphoid. Immobilization followed for 2 months, than remo­val of the K-wires and rehabilitation. X-ray, CT control and DASH testing before the procedure and in a year. Results. Five patients (45 %) had a distinct positive clinical and radiological dynamics, definite positive changes on CT (pathological fracture consolidation, lunate bone remodeling), as well as DASH scale improvement, maintenance of wrist joint radiometric parameters and an increase in strength and range of motions in the wrist. Four patients had no significant dynamics, and in two patients there was a distinct decline in function, advance lunate bone destruction, and an increased wrist joint instability. Conclusions. The technique requires advance revision of the conditions under which it demonstrates its effectiveness. Today it can be recommended in addition to other surgical procedures (shortening of the radius, STT arthrodesis), which have more predicted effectiveness.

Author Biographies

м Tymochenko,  SI «Institute of traumatology and orthopedics of National Academy of Medical Sciences of Ukraine», Kyiv

PhD

Igor Gajovich, SI «Institute of Traumatology and Orthopaedics of the NAMS of Ukraine», Kyiv

PhD

References

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How to Cite

Tymochenko м., Gajovich, I., Аbbasov S., & Lysak А. (2023). Efficiency of concentrated bone marrow aspirate combination with temporary fixation of the scaphoid-trapezius-trapezoidal joint in Kienbeck’s disease. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 43–48. https://doi.org/10.15674/0030-59872020443-48

Issue

No. 4 (2020)

Section

ORIGINAL ARTICLES

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Copyright (c) 2021 Sergey Tymochenko, Igor Gajovich, Sаmir Аbbasov, Аndrij Lysak

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