Volume 9, Issue 1 (2-2022)                   J. Res. Orthop. Sci. 2022, 9(1): 25-36 | Back to browse issues page

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Najd Mazhar F, Moztarzadeh M, Sharifi A M, Mirzaei A. Effects of Core Decompression and Local Deferoxamine Injection on Clinical Outcomes and Revascularization of Lunate Carpal Bone in Kienböck‎ Disease: A Pilot Study. J. Res. Orthop. Sci. 2022; 9 (1) :25-36
URL: http://jros.iums.ac.ir/article-1-2191-en.html
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Pharmacology, Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (680 Views)
Background: Avascular necrosis of the lunate or Kienböck‎ disease is a rare disorder with unknown etiology and challenging treatment. 
Objectives: In this study, we evaluated the effects of local deferoxamine injection as an angiogenic molecule and core decompression to treat Kienböck‎ disease.
Methods: In a pilot clinical trial, 8 patients with stage I to IIIA of Kienböck‎ disease were treated with core decompression and local deferoxamine injection (0.5 mL 500 mg/mL). The outcome measures included wrist range of motions, pinch and grip strength, patient-rated ‎wrist/hand evaluation (PRWE), a short form of disabilities of the arm, shoulder, and hand (Quick-DASH), and visual analog scale (VAS) for pain. The assessment of lunate revascularization was also done by T1- and T2-weighted magnetic resonance imaging. All measurements were done before the intervention and 3, 6, and 12 months after the intervention.
Results: Wrist flexion, extension, ulnar and ‎radial deviation, and pinch and grip strength were continuously improved over the postoperative periods. These improvements were statistically significant. The mean final pinch and grip strength averaged 87.4% and 72.8% of the non-involved hand, respectively. PRWE, Quick-DASH, and VAS scores were also continuously and significantly improved over the study period. The lunate vascularization revealed a continuous improvement in 6(75%) patients.
Conclusion: Local deferoxamine injection in addition to core decompression could improve the radiologic and clinical outcomes of patients suffering from Kienböck‎ disease.
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Type of Study: Research Article | Subject: Hand surgery / Elbow
Received: 2022/01/20 | Accepted: 2022/06/1 | Published: 2022/02/1

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