Having been passionately dedicated to his profession for past 25 years, Dr. Gupta a renowned name in the field of shoulder and upper extremity region stresses, “Kienbocks disease is a rare disease that happens usually in your working hand. It is an occurrence due to clinical failure of lunate bone in your wrist.”
Explaining about the disease in simple terms he says, “There are eight bones in your hand called carpal bones. One of them is lunate which contributes to the movement of the wrist. When blood supply starts to reach this bone insufficiently it becomes damaged or dead making the wrist lose its motion and become painful.”
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Successfully having operated on more than thousands of patients with complex cases Dr. Vikas speaks about this complicated disease with an ease and points out, “Unlike other diseases, in Kienbock’s the condition of your wrist slowly deteriorates and becomes intense so consulting a doctor at an early stage of the disease is advisory to stop further damage to the lunate. The symptoms of Kienbock’s disease can be co-related to pain, tenderness and difficulty in movement of the wrist. As the damage to the lunate increases so does a clunking sound in your wrist as the lunate has broken into fragments inside which make noise when trying to move.”
Dr. Vikas performing surgical treatment on wrists affected by Kienbock’s disease since 1999 as one of the most skillful and efficient surgeons in India while talking about the underlying causes of the disease eminently says, “It is difficult to determine the exact causes of the disease but invariably lack of blood supply to the lunate by arteries or pressure on it by length difference in ulna and radius bone, leads to the disease.”
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In terms of Dr. Gupta, Head, Shoulder and Hand Division, MAX Saket & Gurgaon, former Director ‘The Hand & Upper Extremity Surgery’ at The Medanta Institute of Bone & Joint Disease, Gurgaon, “Diagnosing the disease is not easy as damage to lunate is not visible in the initial X-ray. What it portrays is a possibility of sprain or fracture of your wrist. It is only with supported MRI scan and CT scan that the disease is uncovered and with certain physical examinations and questionnaire we decide the treatment option that is best suited for the patient.”
Being one of the first surgeons in India to use 4, 5 ICRSA vascularised bone graft for Kienbock’s disease Dr. Gupta believes that, “Patients with Kienbock’s disease have to take note of the fact that one type of surgical treatment is not sufficient to relieve them of their pain. Kienbock’s disease is complex yet with skill and expertise by the related surgeon it can be efficiently treated. Usually we perform more than one surgical treatment on patients as the disease progresses to relieve them of their pain and bring back movement in their wrists. Revascularization, joint leveling, proximal row carpectomy are some of the few surgical methods that we perform.”
“All I will say regarding complexities in Kienbock’s disease is that it should be handled by an expert surgeon because any carelessness in treatment can leave you impaired as regards wrist motion”, concludes Dr. Gupta.
FAQ – Kienbock’s Disease
Out of the eight small bones in your wrist called carpal bones, there is a small bone lunate. When blood supply to lunate gets interrupted due to any reason, you are said to be having Kienbock’s disease or avascular necrosis.