Ferdi Sarı, Nezih Ziroglu

Department of Orthopedics and Traumatology, Beylikdüzü State Hospital, Istanbul, Türkiye

Keywords: Capitate forage, Kienböck’s disease, lunate avascular necrosis, lunatomalacia, os lunatum, radial shortening osteotomy, ulnar variance.


Objectives: This study aims to evaluate the efficacy of an alternative method by comparing an old established method with a new less invasive method in the surgical treatment of Stage 3A Kienböck’s disease.

Patients and methods: Between January 2014 and July 2018, a total of 35 patients (28 males, 7 females; mean age: 22.8±3.3 years; range, 17 to 29 years) who underwent surgery due to Kienböck’s disease were retrospectively analyzed. The patients were divided into two groups according to the procedure applied as the capitate forage procedure (CFP) group (Group 1, n=16) and the radial shortening osteotomy (RSO) group (Group 2, n=19). Patients with a minimum follow-up period of 18 months were examined according to the MAYO wrist scores pre- and postoperatively.

Results: The postoperative MAYO scores were statistically significantly higher in both groups (CFP, p=0.001; RSO, p=0.000). However, the osteotomy group showed statistically significantly higher results than the forage group in terms of not only postoperative scores, but also pre- and postoperative score difference (p=0.004).

Conclusion: Our study results confirm that both CFP and RSO are effective in the treatment of Stage 3A Kienböck’s disease. However, RSO should be the first choice in Stage 3A patients with high success rates. Supported by long-term follow-up results, CFP may be considered a minimally invasive alternative only in selected patients who avoid major surgery or expect a rapid return to work.

Citation: Sarı F, Ziroglu N. Comparison of the early-term clinical results of capitate forage procedure and radial shortening osteotomy in Stage 3A Kienböck’s disease. Jt Dis Relat Surg 2022;33(3):599-608.

Ethics Committee Approval

The study protocol was approved by the Bezmialem Vakif University Faculty of Medicine Hospital Ethics Committee (IRB protocol code: 22/06/2020-3000 application ID: 71306642-050.05.04). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Performing surgeries, data collection, manuscript writing: F.S.; Concept, data collection, manuscript writing, critical revision: N.Z.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.