Kienbock's Disease Treatment in West Palm Beach
Kienbock’s disease is an uncommon wrist condition that can be difficult to diagnose and confusing to research on your own. At Palm Beach Regenerative Sport and Spine, Dr. James Ghattas offers a thorough evaluation of your wrist, including a review of your imaging, to help you understand your stage of disease and the full range of options available to you.
For appropriately selected, earlier-stage patients, image-guided orthobiologic injections may be considered as part of a broader treatment plan focused on supporting your body’s natural healing response and managing symptoms.
Results vary. Not all patients are candidates. Dr. Ghattas will discuss realistic expectations for your specific stage of Kienbock’s disease.
What Is Kienbock's Disease?
Kienbock’s disease is a condition in which the lunate, a small bone near the center of the wrist, gradually loses its blood supply. Over time, this can cause the bone to harden, weaken, and in advanced cases, collapse or fragment. The exact cause is not fully understood, but it is generally associated with a disruption in blood flow to the lunate. Contributing factors may include prior wrist trauma, unequal length between the two forearm bones (the radius and ulna), or a naturally occurring variation in the shape of the lunate itself.
What Are the Symptoms of Kienbock's Disease?
- Wrist pain that tends to worsen with gripping, lifting, or weight-bearing activities
- Swelling and tenderness, usually centered over the back of the wrist
- Stiffness and a gradual loss of wrist motion
- Decreased grip strength
- In later stages, a clicking or grinding sensation with wrist movement
How Is Kienbock's Disease Staged, and Why Does It Matter?
Kienbock’s disease is generally described in four progressive stages, ranging from early changes in blood flow to eventual bone collapse and, in the most advanced cases, arthritis of the surrounding wrist joints. Because the disease can behave very differently depending on how far it has progressed, staging plays a central role in deciding which treatments are worth considering. Dr. Ghattas will use X-ray and, when appropriate, MRI imaging to determine your stage before discussing treatment options.
How We Approach Kienbock's Disease
For carefully selected patients in the earlier stages of Kienbock’s disease, before significant bone collapse has occurred, image-guided orthobiologic injections, such as bone marrow concentrate, may be considered. These treatments are performed under ultrasound or fluoroscopic guidance and are intended to help address inflammation and support your body’s natural healing processes in and around the affected bone.
These treatments do not reverse bone collapse that has already occurred, and they are not a substitute for surgical evaluation in more advanced disease. Kienbock’s disease can progress over time, and patients in later stages, or those who do not respond to conservative measures, are often better served by surgical options such as joint leveling, revascularization procedures, or wrist salvage surgery. Dr. Ghattas will provide an honest assessment of where you fall on that spectrum.
Who May Be a Candidate for Orthobiologic Treatment?
Kienbock’s disease treatment with orthobiologics is generally best suited to patients who:
- Are in an earlier stage of disease, before significant bone collapse or fragmentation
- Have not yet developed secondary wrist arthritis
- Have a clear diagnosis confirmed by imaging (X-ray and/or MRI)
- Are interested in exploring non-surgical options before considering surgery
When Surgery May Be More Appropriate
For patients with advanced-stage Kienbock’s disease, including bone fragmentation, collapse, or established wrist arthritis, surgical intervention often provides more reliable, longer-term results. Dr. Ghattas will refer you to a hand and wrist surgeon when surgery is the more appropriate path.
What to Expect
- Consultation: A detailed history, physical examination, and review of your wrist imaging to confirm diagnosis and stage.
- Treatment: If you are a candidate, an image-guided injection performed under ultrasound or fluoroscopic guidance.
- Recovery: Most patients resume light activities within days, with a period of activity modification recommended for the wrist.
- Follow-up: Structured follow-up to monitor your symptoms and, when appropriate, repeat imaging to track the condition over time.
Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery may be more appropriate.
Frequently Asked Questions
For some patients in the earlier stages, non-surgical approaches, including orthobiologic injections, may be part of a broader treatment plan. Whether this is appropriate depends on your specific stage of disease, which Dr. Ghattas will determine through imaging.
Kienbock's disease tends to progress over time without intervention, and the timeline can vary significantly from patient to patient, ranging from months to years. Because of this, an early evaluation is recommended.
No. Kienbock's disease begins as a disruption in blood supply to the lunate bone, though it can eventually lead to wrist arthritis if it progresses without treatment.
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"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
