Abstract
The medial femur provides a source of convex osteochondral vascularized bone. The morphology of the medial trochlea has been shown to have similar contour to the proximal lunate. This analogous structure offers the ability to provide reconstruction of the avascular lunate and restoration of carpal height in advanced Kienböck’s disease. This chapter reviews the author’s clinical experience with this technique and the available published data. The indications, surgical technique, postoperative management, and clinical and radiographic results are presented. Future directions of research are discussed, including donor site morbidity and the relevance microvascular perfusion of the transferred osteochondral segment. Early clinical experience with medial femoral trochlea reconstruction of the diseased lunate demonstrates a successful restoration of the carpal height and lunate morphology with excellent viability and union rates, acceptable ROM, and good pain relief. This is a promising tool for reconstruction of advanced Kienböck’s disease in younger patients.
Original language | English (US) |
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Title of host publication | Kienbock's Disease: Advances in Diagnosis and Treatment |
Publisher | Springer International Publishing |
Pages | 215-225 |
Number of pages | 11 |
ISBN (Electronic) | 9783319342269 |
ISBN (Print) | 9783319342245 |
DOIs | |
State | Published - Jan 1 2016 |
Keywords
- Descending geniculate artery
- Kienböck’s disease
- Medial femoral condyle
- Medial femoral trochlea flap
- Osteocartilagenous autograft
- Vascularized bone
ASJC Scopus subject areas
- General Medicine