Central wrist pain
A deep ache may worsen with activity.
Lunate osteonecrosis · Wrist
Kienböck’s Disease Treatment in Manchester
Kienböck’s disease occurs when the lunate bone loses its blood supply and gradually weakens or collapses. Early diagnosis and accurate staging help determine whether the wrist can be unloaded, the lunate can be preserved or a salvage procedure is needed.
Central wrist painStiffnessWeak gripLunate collapse
Manchester · UKUK-trained wrist specialist · Manchester, UAE & UK consultations
Patient guideSymptoms → Diagnosis → Treatment → Recovery
Specialist hand & wrist assessment
What is it?
Loss of blood supply to the lunate, one of the eight carpal bones.
How found
X-rays may become abnormal later; MRI can detect earlier disease.
Treatment goal
Reduce load, preserve the lunate where possible and maintain useful function.
Surgery
Choice depends heavily on stage, anatomy and surrounding cartilage.
Understanding the condition
What is Kienböck’s disease?
The lunate is a central carpal bone that helps transfer load through the wrist. In Kienböck’s disease its blood supply is disrupted, leading to osteonecrosis, weakening and possible collapse.
The cause is not always clear. Anatomy, repetitive load and previous injury may contribute. Treatment is stage-specific and should be planned by a wrist specialist.
Clear diagnosis before treatmentSimilar symptoms can arise from the neck, elbow, wrist, tendons or joints. The examination is designed to locate the true source.
What patients may notice
Symptoms worth checking early.
Symptoms vary with the injured wrist structure and how long function has been affected. Persistent pain, clicking, stiffness, weakness or instability deserves specialist assessment.
Swelling
The back of the wrist can appear full.
Reduced motion
Flexion and extension may become restricted.
Weak grip
Pain and carpal change reduce strength.
Tenderness over the lunate
The centre-back of the wrist may be sensitive.
Progressive symptoms
Pain can become more constant as collapse advances.
Why it happens
Why the lunate loses blood supply
A useful consultation connects pain location, stability, imaging and function to the exact wrist structure—not just the label.
Anatomical variation
Forearm-bone length and lunate shape can alter load.
Repetitive microtrauma
Repeated loading may contribute in susceptible wrists.
Single injury
Trauma may disrupt blood flow in some patients.
Unknown factors
Many patients have no single identifiable cause.
Focused diagnosis
Find the structure, the stability and the severity.
Diagnosis requires staging: whether the lunate is only abnormal on MRI, has become sclerotic, has collapsed, or has led to secondary arthritis.
Bring to your appointmentPrevious X-rays, MRI scans, reports, braces and information about work, sport or activities that trigger symptoms.
Clinical assessment
Pain, motion, grip and tenderness are recorded.
X-rays
Density, fracture, collapse and carpal alignment are assessed.
MRI
MRI can detect early blood-supply change and cartilage condition.
CT in selected cases
CT can define fracture and collapse for surgical planning.
Treatment choices
Start with the option that fits the diagnosis.
Surgery is not automatic. Treatment is matched to pain, stability, cartilage condition, imaging and the patient’s goals.
Non-surgical care
Reduce irritation, protect function and review progress.
- ImmobilisationA cast or splint may reduce pain in early or mild disease.
- Activity modificationLimit heavy axial loading and repetitive impact.
- Pain managementAppropriate medication may help symptoms.
- Hand therapyTherapy maintains motion and function but does not reverse loss of blood supply.
- Serial imagingProgression is monitored because treatment can change with stage.
Surgical pathway
Match the operation to the stage of lunate collapse and remaining cartilage.
- Joint-levelling procedureThe radius or ulna may be adjusted to reduce load on the lunate in suitable anatomy.
- RevascularisationSelected early-stage cases may be considered for a vascularised bone graft.
- Lunate or carpal reconstructionOptions depend on collapse and surrounding cartilage.
- Salvage procedureProximal row carpectomy or fusion may be considered when collapse and arthritis are advanced.
Surgery when appropriate
Kienböck’s disease surgery
There is no single operation for every stage. The plan depends on bone anatomy, lunate collapse, wrist alignment, cartilage condition, age and activity.
- Confirm the disease stage with imaging
- Assess ulnar variance and surrounding cartilage
- Choose unloading, revascularisation, reconstruction or salvage
- Protect the wrist while bone and soft tissue heal
- Progress motion and strength according to the procedure
Realistic expectationsThe aim is to reduce pain and preserve useful wrist function. No treatment can guarantee that the wrist will become completely normal.
Specialist pathwayDiagnosis → Procedure → Therapy → Recovery
Recovery pathway
Healing is staged—not rushed.
Timelines are guides only. The diagnosis, procedure, stability, cartilage condition, job and associated injuries all influence recovery.
Early phase
Immobilisation and swelling control depend on the procedure.
6–12 weeks
Bone healing and wrist motion are reviewed.
3–6 months
Strength and functional use progress gradually.
Longer term
Recovery and disease monitoring can continue for a year or more.
4.96/555 verified reviewsWhy consult Dr. Arshad
A clear diagnosis. Practical options. A plan built around you.
Dr. Shoaib Arshad is a fellowship-trained consultant orthopaedic hand and wrist surgeon with UK specialist training and more than 17 years in orthopaedic surgery.
Focused hand, wrist and upper-limb assessmentNon-surgical and surgical treatment pathwaysConsultations in Manchester and across the UK, and at Healthpoint Abu Dhabi
Meet Dr. Arshad ↗Questions patients ask
Kienböck’s Disease FAQs.
General information only. Your diagnosis and treatment plan should be based on an individual medical assessment.
Is Kienböck’s disease arthritis?+
It begins as loss of blood supply to the lunate. Arthritis can develop later if the bone collapses and wrist mechanics change.
Can it be seen on a normal X-ray?+
Early disease may have a normal X-ray, while MRI can detect changes sooner.
Can therapy cure it?+
Therapy can help maintain motion and function but does not restore the lunate blood supply.
Why are there so many different operations?+
Each stage has different anatomy and cartilage damage, so treatment ranges from unloading to reconstruction or salvage.
Can I get a second opinion in Manchester?+
Yes. Dr. Arshad can review symptoms and imaging in Manchester, UK and during UK clinical availability.
Medical referencesPatient information sources used for this guide
Manchester · UK & Abu Dhabi consultation availability
Ready for a clear wrist assessment?
Book a specialist consultation and bring any previous X-rays, MRI scans, reports, braces or treatment information.