Pathoanatomy of Kienböck’s Disease

Chongjin Yeo, Gregory I. Bain, Levi Philip Morse

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

    Abstract

    Understanding the pathoanatomy of the lunate and Kienböck’s disease will be an important step towards unraveling Kienböck’s disease. This chapter explores the pathological changes of normal bone and cartilage following trauma and an ischemic episode. With ischemia, fat cells become swollen, which compromises the venous drainage. With repeated ischemia, the marrow becomes fibrotic and scarred, which further compromises the vascularity. When the bone is initially challenged, it compensates, but with repeated insults, it then becomes compromised, and ultimately will fail, in the form of a fracture and fragmentation. Even in late stages of avascular necrosis the bone does have areas of vascularity, which do respond to the challenges placed upon it, as described by Wolfe’s law. The articular cartilage receives its oxygenation from the synovial fluid, so it is not reliant on the osseous vascularity. However the ischemia leads to fracture of the subchondral bone plate, which then compromises the function of the articular cartilage and then the joint.

    Original languageEnglish
    Title of host publicationKienbock's Disease
    Subtitle of host publicationAdvances in Diagnosis and Treatment
    EditorsDavid M. Lichtman, Gregory Ian Bain
    Place of PublicationSwitzerland
    PublisherSpringer International Publishing
    Chapter6
    Pages53-63
    Number of pages11
    ISBN (Electronic)9783319342269
    ISBN (Print)9783319342245
    DOIs
    Publication statusPublished - 2016

    Keywords

    • Basic science
    • Etiology
    • Kienböck’s disease
    • Pathoanatomy
    • Pathology

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