Mesenchymal stem cells injection with core decompression in the treatment of Kienbock disease

Abstract

Treatment of Kienbock disease (the avascular necrosis of the lunate) is a matter of debate. Current surgical modalities have their limitations and potential complications. Those modalities are also not based on pathophysiology of the disease. Here we introduce a novel therapeutic option by combining the autologous mesenchymal stem cell injection and the core decompression procedure in the treatment of Kienbock disease. We hypothesized that micro-drilling of the lunate removes the necrotic tissue and induces new bone formation while injection of mesenchymal stem cell provides a poll of multi-potent cells to replace the dead bone. This new treatment modality would provide synergistic effects of the two therapeutic options beside lower potential complications while eliminating the need for current surgical operations.