Are Salvage Procedures Really Necessary for Kienbock’s Disease Stage IV? A Systematic Review

Description

This presentation features Brynn Charron, a medical student at Western, who discusses a systematic review on Kienbock's disease, particularly focusing on Stage I and the necessity of salvage procedures. Brynn highlights the current lack of strong evidence for recommending specific interventions in late-stage Kienbock's disease and explains that the disease's natural history is still unclear. The systematic review assesses various treatment modalities explored in 24 studies published between 1989 and 2019, analyzing their effectiveness based on outcomes like pain relief, range of motion, and grip strength.



The review categorizes treatment options into conservative management, non-salvage procedures, and salvage procedures, indicating the treatments provided varying degrees of pain relief and functional improvement. Interestingly, while salvage procedures resulted in lower range of motion compared to other methods, grip strength improvement was noted across treatments. Brynn concludes by emphasizing that there is no universally superior treatment for Stage IV Kienbock's disease, and discusses the relevance of non-salvage procedures for young, physically active patients. The study identifies limitations such as the rarity of Kienbock's disease and the need for multicenter trials to enhance data robustness, highlighting the importance of standardized outcome measures in future research. The presentation ends with a thank you for the audience's attention.

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