Kienbock Disease in Patients Over Age 70
Older patients with Kienbock disease represent a distinct prognostic group. The clinical course and the approach to management in this population differ meaningfully from younger adults, and evidence supports recognising this age threshold as a separate category from the outset.
Clinical Scenario
This protocol applies to patients with Kienbock disease who are over 70 years of age. This age group is treated as a separate prognostic category, as outcomes data show a distinct natural history compared to younger patients.
Treatment Approach
In patients over 70, the initial approach centres on nonoperative management. Even with radiographic progression, this population has shown notably favourable clinical outcomes without surgical intervention.
The full structured regimen — including the specific components of nonoperative care and the decision framework — is available via the link below.
References
DOI: 10.1055/s-0037-1604137
A3 > 70 years: Usually responds to nonoperative management.
As these are different prognostic groups, we have separated them from the start.
At a mean follow-up of 5.6 years, all 15 patients progressed to stage IV disease but had good-to-excellent clinical outcomes without surgery.
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