Health condition
Kienböck disease
Kienböck disease is avascular necrosis of the lunate - a small bone at the centre of the wrist - causing progressive wrist pain and stiffness in young adults; staged treatment ranges from offloading procedures to partial fusion, and early diagnosis widens the options.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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Typical patient: a young adult (often manual worker) with months of central dorsal wrist pain, weak grip and stiffness, sometimes after modest injury
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X-rays can be normal early; MRI detects the failing blood supply before the lunate sclerosis, fragmentation and collapse of later stages
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Ulnar variance matters: a relatively short ulna concentrates load on the lunate and shapes surgical choices
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Stage-matched treatment: immobilisation early, radial shortening osteotomy or revascularisation in the middle stages, and salvage procedures (proximal row carpectomy, partial fusion) once the lunate collapses
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
The lunate sits at the keystone of the wrist under high compressive load, fed by a fragile blood supply - the combination that makes it vulnerable. As its bone dies and softens, the carpus loses height and alignment, so what begins as an ache with gripping progresses over years to stiffness and arthritis; because early X-rays look normal, young people with persistent central wrist pain are too often reassured instead of scanned.
Diagnosis and treatment routes
A hand surgeon stages the disease (Lichtman classification) with X-ray, MRI and often CT, then matches treatment: splinting and activity modification may serve the earliest stage, radial shortening osteotomy reliably offloads the lunate where the ulna is short, vascularised bone grafting can rescue selected pre-collapse wrists, and once collapse and arthritis arrive, proximal row carpectomy or scaphocapitate fusion trade some motion for lasting pain relief. Grip retraining with hand therapy runs through every pathway. In much of the UK, a routine NHS referral to the relevant specialist clinic can take several months, whereas an initial appointment with a private consultant is typically available within around two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant hand and wrist surgeon. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Kienböck disease.
Quick, plain-English answers to what people ask us most.
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What is Kienböck disease?
Kienböck disease is a condition in which one of the small bones in the wrist, the lunate, loses its blood supply and gradually breaks down (avascular necrosis). It typically affects young adults and causes progressive wrist pain and stiffness.
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What causes Kienböck disease?
The exact cause often isn't clear, but it's thought to relate to disrupted blood supply to the lunate bone, sometimes following injury, repetitive strain, or in people whose forearm bone lengths (the ulnar variance) predispose them to it. It typically affects one wrist rather than both.
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What are the symptoms of Kienböck disease?
Symptoms include wrist pain and swelling, stiffness, reduced grip strength and, as the disease progresses, restricted wrist movement. Symptoms often start gradually and can be mistaken for a simple wrist strain initially.
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Is Kienböck disease serious?
If untreated, it can progress to significant wrist arthritis and collapse of the bone structure, causing long-term pain and reduced function. Early diagnosis and treatment can help preserve wrist function and slow or halt progression.
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Is Kienböck disease hereditary?
It is not typically considered a hereditary condition, though the anatomical variations in forearm bone length that increase risk can run in families to some extent. Most cases occur without any family history.
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Can Kienböck disease be cured?
Early-stage disease can sometimes be effectively treated with procedures aimed at restoring blood flow or offloading the lunate, potentially halting progression, but once significant bone collapse has occurred, treatment focuses on managing symptoms and preserving function rather than reversal. Early diagnosis significantly improves outcomes.
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How is Kienböck disease treated?
Treatment depends on the stage at diagnosis, ranging from splinting and anti-inflammatory treatment in early mild cases, to surgical procedures such as joint levelling, bone grafting, or in advanced cases, wrist fusion or salvage procedures. A hand surgeon will recommend the best option based on imaging staging.
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How long does recovery from Kienböck disease treatment take?
Recovery varies by treatment type, ranging from a few weeks for conservative management to several months of rehabilitation following surgical procedures. Your surgeon will give a personalised timeline based on the specific intervention used.
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When is surgery needed for Kienböck disease?
Surgery is generally considered when symptoms persist despite conservative treatment, or when imaging shows progressive bone collapse threatening long-term wrist function. The specific procedure chosen depends on the disease stage at the time of assessment.
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When should I see a specialist about Kienböck disease, and how quickly can I be seen privately?
Persistent wrist pain and stiffness that isn't improving with rest should be assessed by a hand specialist, as early treatment offers the best outcomes. Private hand surgery consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.