Preiser's disease: arthroscopic treatment of avascular necrosis of the scaphoid.

Abstract

We report the case of a 50-year-old female patient with Preiser's disease (avascular necrosis of the scaphoid) who, after a 2-year history of wrist pain, underwent arthroscopic debridement of the necrotic scaphoid using a standard technique. Osteoarthritic changes of the articular cartilage, partial rupture of the scapholunate ligament, local synovitis, and loose fragments were documented. The patient reported significant improvement in pain relief and complete relief of mechanical symptoms at 31-month follow-up examination. Radiographs demonstrated no progression of collapse of the scaphoid or acceleration of degenerative changes in the wrist. Arthroscopy in Preiser's disease allows direct visualization and assessment of the exact pathology of the radiocarpal and midcarpal joint and the scaphoid cartilage. Arthroscopic debridement of the necrotic scaphoid increased wrist functional range of motion, provided excellent pain relief, and improved health-related quality of life.