Kienbock Disease Management in Patients Over 70 Years
Patients over 70 years with Kienbock disease represent a distinct prognostic group.
Their clinical course and treatment pathway differ meaningfully from younger patients,
and this age-specific context shapes which interventions are appropriate.
Clinical scenario
Patients in this age group typically follow a different natural history from younger adults.
This population usually responds to nonoperative management, and as a distinct prognostic
group they are evaluated and treated along a separate pathway from the outset.
Treatment approach (partial overview)
When surgical intervention is indicated — for example after an adequate period of conservative
management — the options considered in this protocol centre on a synovectomy-type procedure
or an approach targeting mechanical load on the affected carpal bone.
The complete decision algorithm, sequencing, and all clinical criteria are in the full protocol.
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.
Consider synovectomy or proceed according to the protocol described below for symptoms > 6 months.
Synovectomy and joint debridement can be performed as an open or arthroscopic procedure.
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