So,
there is still (surprise surprise) no known cause of Kienböck’s. However, there
are more documented cases then there were in 2009 when my disease was
discovered. That doesn’t mean there are more published materials or that doctors
know new information because largely, they are still in the dark due to the
rarity of the disease. Moreover, since I’m female, I fall into the minority of cases,
which makes it a little more difficult because believe it or not, women have
different bone structures.
Still,
most doctors and therapists have not heard of the disease. In my current
occupational therapy, interns from the local colleges who are completing their
occupational therapy degrees have never heard of it – in class or in their
books. This is rather unfortunate for me because I had to seek out the top hand
surgeon in my region and request that he look at my case before deciding to
take me on as a patient. Dr. L is very knowledgeable on the subject matter as
he is one of the best hand surgeons in the country and has done a lot of research
that is unable to be conducted at my laymen/patient level. Kienböck’s is listed
as a rare bone disease due to the extremely low level of population affected.
There are still fewer than 200,000 known cases in the U.S. alone.
Here’s
an interesting tidbit: A study done on Kienböck’s disease could only be
completed on 50 patients. I’m sure that every single one of them would be happy
to know that their cases are all extremely different since Kienböck’s is no appendectomy.
(Ha-ha, medical humor!) BUT, there have been interesting developments.
Synthetic lunate replacements are NOT working. That’s what I find promising.
There are some small developments that are helpful in determining what
treatment procedures should be done. Since Kienböck’s is a highly degenerative
bone disease, this could help people like me in the long run because this is
not a cheap disease and it is life altering.
Dr.
L is hoping that with my recent pedicled vascularized bone graft that the
lunate can be saved, which is #1 priority with any Kienböck’s patient. The
problem is that at some point, a large percentage of people with later stage Kienböck’s
will have to have it removed or fused. Dr. L knows that my condition is bad and
is very honest with me that my prognosis does not look good. I see his concern
with my pain level as maintaining the state of the disease to where it is
manageable. I agree, it needs to be managed.
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