I've had Kienböck's disease of the wrist for three years now. It's gradually getting worse. I know I'll need surgery eventually. But how can I tell when the time is right?

You can depend on your orthopedic surgeon to advise you. Having regular check-ups will help show any changes that have occurred over time and how rapidly they are progressing. Some people rely on their symptoms. If pain and loss of motion, strength, and function are great enough, then surgery may be the best choice.

For some people with this condition, pain occurs with everyday activities. Severe, disabling pain may prevent them from completing daily activities at home or at work. X-rays can show if there is breakdown of the affected bone and/or joint. Though symptoms don't always match what's going on in the X-ray, changes in the bones or joints must be considered.

There are procedures available to restore blood flow to the area. Removing a bone or a row of carpal (wrist) bones takes the pressure off the wrist. Reducing compression can help revascularize the area.

Reference: 

Boyd C. Lumsden, MD, et al. Treatment of Advanced-Stage Kienböck's Disease with Proximal Row Carpectomy: An Average 15-Year Follow-Up. In The Journal of Hand Surgery. April 2008. Vol. 33A. No. 4. Pp. 493-502.

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