Approximately 20 months ago, I began experiencing pain like a sprained wrist, but with no apparent reason. As I normally heal quickly, I did nothing and put up with it. The pain eventually got to the point where I could not play my flute for more than 15 seconds without my wanting to throw the instrument out of the window.

I decided to go for the 'holistic' approach for once. I went to a highly recommended chiropractor. His x-rays (included) showed nothing unusual, and things were getting better until he began working on the wrist itself. Things then got abruptly much worse again.

I went to a highly rated local orthopedic surgeon who specializes in hands. He originally treated me for a bad, unhealed sprain. After no relief, he took office x-rays (included) and diagnosed Kienbock's Disease. In spite of my ulna and radius being absolutely equal, as both noted on the x-ray and muttered to himself, he wanted to schedule me for surgery immediately for radial shortening.

As that would have eliminated my playing in a band I was in for the summer, I told him I wanted to put it off. He said that things might progress, but to call him when I was ready.

I shipped copies of my x-rays to my brother, who runs a major radiology center. He showed them to the orthopedic people who agreed that it looked like Kienbock's, and also agreed (with me) that radial shortening would not be the right thing in my case. They suggested a titanium implant, and gave me the name of the company who makes them.

Their site led me to a local doctor who had already been recommended to me. He ordered an MRI which showed category 3b-4 Kienbock's. He would have preferred a fusion but, as I was adamant about being able to play the flute afterwards, he agreed to the implant.

It took 4 ½ months to get the implant made. I had surgery on February 23 of 2005, 16 months after first noticing the symptoms. The surgeon found the lunate to be "complete mush - no hope whatever of saving it".

The doctor cast my wrist in such a way that I could still play, and I was in the splint followed by the cast for only 5 weeks total. After that, he told me to take it easy and wear a brace if I were doing anything strenuous with the left hand. One internal suture did not dissolve and caused a problem, but the doctor cut it out and gave me antibiotics just in case. I had no other problems.

I am now 14 weeks post-op and could not be happier. I do not have full range of motion, as shown by the tests from 1 ½ weeks ago, but it is close to the non-injured wrist. My strength is also within normal limits for the off-hand at my age, but near the bottom of the scale. I can play the flute totally pain free; I can do all normal activities pain free. When my hand is at rest, it is if I had never gotten Kienbock's. I only feel slight twinges if I really overdo, and then I find a way around it.

I know, I keep trumpeting this procedure, but I have gotten even more reason to do so.

I had my grip tested recently in my right hand and asked if I could see what the left hand was doing. It was only 2 lbs less than my dominant hand!

I happened to be near my surgeon's office this morning, so I stopped in to give him the results. He checked ROM and took x-rays. The ROM is now + and - 45 degrees. The x-ray showed that the capitate, which was showing a bit of arthritis pre-surgery has not changed at all from the original post-op x-rays.

To sum things up, I have regained much of my ROM (my right hand isn't a whole lot more), all of my grip strength, and have NO further changes whatever in the adjacent bones. I have even gone back to my original bicycle - instead of the recumbant which I bought and HATE - with no pain.

The doctor said that he was thrilled and thanked me for stopping by. He also said that the original problem with even this procedure was using pre-sized implants. He had this one custom made to the exact size and shape of the original lunate, and that seems to be the secret. Yes, it is the same company, Wright Medical.

If you read my original posting in 'darker blue', you will see that I had very little cast time, and very little pain. I am NOT a teen- ager - rather the opposite at 64.

All in all, I must recommend that people talk seriously with their surgeons about this procedure instead of fusions or other extreme proceures. I was stage 3b-4 when diagnosed, and things had progressed to where the lunate was "total mush" by surgery time. Make certain, of course, that a CUSTOM implant made to the exact dimentions of the original lunate is used.