Kienbock's Disease and the Risk Factors Associated with Reoperation: A SPARCS Database Review over 10 Years.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Kienbock's disease (KD) is a condition affecting the lunate bone in the wrist.
• Surgical management is common for KD, but revision rates and associated risk factors require further investigation.
• Large-scale data is needed to understand long-term outcomes of KD surgery.

Purpose of the Study:

• To identify risk factors for revision surgery in patients with Kienbock's disease (KD).
• To determine the revision rate in patients who underwent operative treatment for KD.
• To compare revision rates between KD patients and a control group with wrist osteoarthritis.

Main Methods:

• Utilized the New York Statewide Planning and Research Cooperative System database (2011-2021).
• Identified patients with KD diagnosis undergoing surgery and a control cohort with wrist osteoarthritis.
• Performed statistical analysis using R version 4.2.2 to compare cohorts and identify risk factors.

Main Results:

• The KD cohort (499 patients) was younger, had more females, and higher obesity rates than controls (6,823 patients).
• The overall revision rate for KD patients was 12%; however, KD patients had a lower revision rate than controls over 10 years.
• Worker's compensation status was a risk factor for revision, while older age, male sex, obesity, and higher Elixhauser Index were protective.

Conclusions:

• Surgical treatment for Kienbock's disease (KD) is associated with a lower revision rate over 10 years compared to arthritic controls.
• Despite a higher overall KD revision rate (12%) in this multi-institutional study compared to single-institution data, it remains favorable relative to non-KD controls.
• Understanding risk and protective factors is crucial for optimizing surgical outcomes in KD patients.