Preiser’s Disease (AVN of the Scaphoid): a Leading Hand Surgeon From India Consults Dr. Dennis Lox For a Rare Form of Avascular Necrosis (AVN)
Tampa, Saint Petersburg and Clearwater, FL
Preiser’s Disease is non-traumatic AVN of the scaphoid which is a rare occurrence. Post- traumatic AVN of the scaphoid bone, especially after fracture is not uncommon. Preiser described this condition in 1910. Yet all of Preiser’s cases were associated with trauma or fracture, therefore he was more apatly describing post-traumatic scaphoid AVN. True non-traumatic or idiopathic scaphoid AVN appears infrequently in the medical literature and therefore is a rare form of AVN. Avascular necrosis (AVN) also referred to as Osteonecrosis develops when the blood supply to a region of bone becomes disrupted leading to bone cell death (necrosis). In the case of the scaphoid, blood supply is derived from the lateral and distal branches of the radial artery.
This occurs by dorsal and palmar branches. The dorsal branch is highly variable, and the proximal portion is often left with little support. It may be overlooked on x-rays early on. If the scaphoid becomes necrotic it may collapse and affect wrist mobility, as the scapho-lunate articulation is important in stability of the first carpal row. Stem cells have been utilized for treatment of AVN. Stem cells may not only repair bone cells (osteocytes), but are involved in angiogenesis (the formation of new blood vessels). Therefore, stem cells may be a viable treatment option for scaphoid AVN, if the joint integrity is still maintained. After the joint collapses, rapid secondary degeneration occurs.
The use of Regenerative Medicine procedures such as Platelet Rich Plasma (PRP), Stem Cells, and Cytokines all may play an important role in the treatment of AVN.
Dennis M. Lox, M.D., serves patients in the greater Tampa Bay area, including, Clearwater, St. Petersburg, Tampa, New Port Richey, Sarasota, Orlando and Spring Hill. He has been pleased to accommodate the needs of patients throughout Florida, the United States, the Western Hemisphere, and Europe, as well. Located in the 33765 area, our office can be reached at (727) 462-5582.
