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Capitate Shortening Osteotomy for Kienböck's Disease: A Systematic Review
Natasha Simske1,2, Mohammed Pourghaed1,2, Cole Johnson1,2
1Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Fort Bliss, TX, USA.
Hand (New York, N.Y.)
|May 10, 2026
Summary
Capitate shortening osteotomy (CSO) improves pain and function in early Kienböck's disease. However, failure rates are high, necessitating further research into risk factors for poor outcomes.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Bone healing research
Background:
- Kienböck's disease involves lunate bone avascular necrosis.
- Traditional treatments focus on decompression and revascularization.
- Capitate shortening osteotomy (CSO) is an emerging alternative for early-stage disease.
Purpose of the Study:
- To aggregate clinical and patient-reported outcomes of isolated CSO for Kienböck's disease.
- To evaluate the efficacy of CSO in early-stage Kienböck's disease.
- To identify potential risk factors for treatment failure.
Main Methods:
- Systematic literature search of PubMed and CINAHL (1994-2024).
- Inclusion of studies reporting operative, radiological, or functional outcomes with ≥1-year follow-up.
- Exclusion of studies with concomitant procedures.
Main Results:
- 10 studies including 141 patients (Lichtman stage 2 or 3A) met criteria.
- Significant improvements in Visual Analogue Scale and Disabilities of the Arm, Shoulder, and Hand scores.
- Overall disease progression rate of 10.9% and lunate revascularization in 78% of patients.
Conclusions:
- Capitate shortening osteotomy is a viable option for pain and functional improvement in Kienböck's disease.
- High failure rates necessitate further investigation.
- Identifying risk factors for failure is crucial for optimizing treatment outcomes.
