Bone metabolism changes of the carpal bone after operative treatment of carpel lunate avascular necrosis (Kienbock's disease)

The aim of the study was to establish the bone metabolism changes of the carpal bone after operative treatment of carpal lunate avascular necrosis. Subjects of our study were 16 patients (pts) with avascular necrosis of the carpal lunate. Becks method was performed in 7 pts (group I) and Level-operation in 9 pts (group II). All patients underwent bone scintigraphy after intravenous injection of 10 mCi Tc-99m-methylene diphosphonate (Tc-99m-MDP) one week after the operation and 6 months Later. The bone metabolism was assessed by the regional skeletal index of the carpal bone. The value of 1,15 ware adopted as normal. Increased bone metabolism was established in all patients one week after the operative treatment. An increased skeletal index was detected mainly in the lunate. scaphoideum and capitatum bones. The high bone metabolism 6 months after the operation was improved in 3 pts (group I) and in 2 (pts group II). The rest of the patients showed a tendency to decrease or normalize bone metabolism 6 months after the operation. Our study confirmed that the bone metabolism of the carpal bone was increased one week after the operative treatment in Kienbock's disease, The bone metabolism was normalized in 57 % of the patients 6 months after the Beck's method and in 78 % of the patients after the Level-operation.