Kienbock’s disease

Have you been suffering from persistent wrist pain that seems to worsen as time goes on? It might be more than just a passing discomfort. Welcome to our comprehensive guide on Kienbock’s disease, a condition that can significantly affect your wrist health and function. At the Sydney Orthopaedic Surgeon Clinic, we’re dedicated to providing specialised care for conditions like Kienbock’s disease, and we’re led by the experienced hands of Dr Stuart Kirkham.

Kienbock’s disease is a complex condition that impacts the bones of the wrist, particularly the lunate bone. This can result in pain, limited wrist movement, and potentially impact your everyday activities. With over 25 years of experience, Dr Kirkham is a distinguished orthopaedic surgeon renowned for his expertise in diagnosing and treating intricate wrist conditions. His commitment to delivering personalised care has made his five conveniently located clinics leading destinations for those seeking relief from wrist, hand, elbow, and shoulder conditions.

Understanding Kienbock’s disease and how it impacts the hand and wrist is crucial for anyone experiencing wrist pain, discomfort, or reduced mobility. Don’t let wrist pain hinder your daily activities or quality of life. Reach out to us and schedule a consultation with Dr Kirkham, where together, you’ll explore the best strategies to alleviate your discomfort and enhance your wrist’s functionality. Take that important step toward reclaiming your well-being – because you deserve a life free from unnecessary limitations.


A firm grasp of the intricate anatomy of the wrist is key to understanding the complexities of Kienbock’s disease. The wrist consists of various bones, ligaments, and tendons that collaborate to ensure we can make many intricate movements. Among these components, the lunate bone takes centre stage in the context of Kienbock’s disease. Nestled within the wrist’s delicate framework, this moon-shaped bone plays an important role in maintaining proper hand function and alignment.

The lunate bone’s significance becomes clear when discussing Kienbock’s disease. This condition, named after Austrian radiologist Robert Kienböck, revolves around the progressive degeneration of the lunate’s blood supply. The compromised blood flow can lead to a series of different issues, including the deterioration of bone tissue and subsequent pain. Kienbock’s disease typically emerges in the dominant hand’s wrist of individuals aged 17-25, so we assume that the end of skeletal growth in the wrist is a factor in the bone becoming vulnerable to an abnormal blood supply.

Kienbock’s disease doesn’t just affect the lunate; its repercussions ripple through the entire wrist structure. As the lunate weakens due to compromised blood flow, nearby and adjacent bones can experience altered function, resulting in discomfort and limited mobility. Understanding this interplay is vital in determining the condition’s progression and in creating personalised treatment strategies that will be effective for each individual case.

When it comes to specialised orthopaedic care, acknowledging the fundamental role of wrist anatomy and the intricacies of conditions like Kienbock’s disease just showcases how important early intervention can be. Dr Kirkham and his adept team at the Sydney Orthopaedic Surgeon Clinic are always ready to guide patients through comprehensive assessments and tailored treatment plans, ensuring that each individual’s wrist health is maintained, and their quality of life is restored.

Causes and Risk Factors

Kienbock’s disease can be caused by a wide range of factors that deteriorate the overall health of the wrist. Trauma, such as a wrist injury or fracture, can disrupt the delicate blood supply to the lunate bone, triggering the onset of this condition. Alternatively, anatomical variations in the blood vessels that give nourishment to the lunate might also put individuals at risk of developing Kienbock’s disease, purely as a result of the inherent links between genetics and health.

Several risk factors can elevate the likelihood of developing Kienbock’s disease. Age plays a substantial role, as this condition predominantly affects young people between the ages of 17 and 25 when the bones have completed their growth and begin to mature. Gender can also factor in, as the condition inhibits more women than men, but only by a small margin. Jobs that involve repetitive wrist movements or bearing significant weight can also exert stress on the wrist, potentially putting the individual at risk of developing the condition. Underlying health conditions, such as vascular disorders, can also compromise blood flow to the lunate, accelerating the disease’s progression.

Research has also seen correlations drawn between Kienbock’s disease and the bending and twisting of the wrist, which can exert strain on the lunate’s delicate blood supply. Similarly, vascular anomalies have been discovered through imaging studies, and they have offered valuable insights into the condition’s development. These findings have shown that a huge range of different factors can contribute to the development of Kienbock’s disease, so while the condition is rare, it can impact a diverse group of people.

Symptoms and Identification

Kienbock’s disease manifests through a spectrum of symptoms that can vary widely in intensity and presentation. Common indicators include persistent wrist pain, tenderness, and swelling. You might notice reduced grip strength and difficulties while performing tasks that require wrist motion. As the condition advances, stiffness and limited range of motion may also become apparent. Less frequent, but possible symptoms include a clicking sensation during wrist movement or even a noticeable change in wrist size due to muscle atrophy.

Kienbock’s disease progresses through distinct stages, each marked by different symptoms. In the early stages, mild discomfort and occasional pain might be the only signs, often mistaken for strains or overuse injuries. Over time, as blood flow to the lunate deteriorates further, pain can become more frequent and intense. The wrist’s mobility might be notably impaired, affecting your ability to perform even simple activities. This underscores the significance of identifying the condition’s stages to tailor appropriate interventions.

When it comes to the identification of Kienbock’s disease, effective diagnosis generally depends on how early these triggers and vulnerabilities are identified. Fortunately, Dr Kirkham benefits from a fantastic grounding following an interview with Rear Admiral Dr David M Lichtman MD, which then presented him with the opportunity to work in his hand unit in Houston, Texas. 

This invaluable experience, and all of Dr Kirkham’s years of practice since, have given him all the expertise needed to quickly and accurately identify potential risk factors of Kienbock’s disease. His personalised approach ensures that patients receive tailored guidance and recommendations to prevent their specific symptoms from interfering heavily in their daily lives. By addressing the underlying factors, Dr Kirkham empowers his patients to navigate the challenges posed by Kienbock’s disease proactively and with confidence. 

Diagnosis and Imaging

Diagnosing Kienbock’s disease is a meticulous process that usually requires a combination of clinical evaluation, medical history analysis, and advanced imaging techniques. The journey begins with a comprehensive discussion of your symptoms with Dr Kirkham, followed by a physical examination to assess wrist mobility, tenderness, and grip strength. Your medical history, including any previous injuries or conditions, plays a crucial role in helping Dr Kirkham understand the context of your wrist discomfort.

To delve deeper, a few imaging techniques may be used to visualise the intricate structures within the wrist. X-rays are commonly used in this process to give Dr Kirkham an understanding of changes in bone density, alignment, and any potential fractures. Additionally, an MRI can provide detailed images of soft tissues, such as ligaments and tendons, enabling a comprehensive assessment of the wrist’s internal condition.

In this diagnostic puzzle, Dr Kirkham’s many years of practice and exposure to diverse cases have given him the ability to deliver accurate diagnoses in a range of cases. He carefully analyses the information available and combines his clinical findings with imaging results to reach an accurate diagnosis. Through this integrated approach, he distinguishes between Kienbock’s disease and other potential causes of wrist discomfort to make sure an effective treatment plan is arranged.

Dr Kirkham’s fantastic reputation also extends beyond an accurate diagnosis. When delivering these results, Dr Kirkham’s unique approach centres around carefully listening to his patients and ensuring they feel supported throughout the process, giving them all the information and advice they need in what can be a daunting time. With his guidance, patients receive a clear understanding of their condition, paving the way for informed decision-making and effective treatment strategies.

If you suspect you may be suffering from the symptoms of Kienbock’s disease, don’t hesitate to reach out to Dr Kirkham for a consultation and accurate diagnosis of your wrist discomfort. Don’t let wrist pain hold you back any longer.

Treatment Options

A wide range of treatment options are available to address Kienbock’s disease, and Dr Kirkham tailors each of his recommendations to the needs of the individual. Non-surgical approaches are often the initial form of treatment, focusing on alleviating symptoms and ensuring they do not progress and worsen. Immobilisation through splinting or casting can provide rest to the affected wrist, reducing strain and discomfort. Anti-inflammatory medications and corticosteroid injections may also be employed to manage pain and inflammation, enhancing comfort and functionality.

In cases where non-surgical methods prove ineffective, surgical intervention may be considered. The choice of surgical technique Dr Kirkham uses depends on the disease’s stage and its impact on the wrist’s structure. Procedures range from revascularisation, which aims to restore blood flow to the lunate bone, to more extensive surgical procedures like joint levelling, where the bone alignment is adjusted to prevent pressure from being exerted on the lunate.

Dr Kirkham’s great expertise is valuable in helping him select the most suitable treatment path. With over 25 years of practice, he has undertaken each form of treatment several times, and this helps him make well-informed decisions based on individual circumstances. His intimate understanding of the intricacies of Kienbock’s disease allows him to understand the nuances of each case, considering factors such as disease progression, patient preferences, and overall health. By aligning treatment strategies with patient goals, Dr Kirkham empowers his patients to make informed choices, giving them the control they need to improve their well-being.

Whether opting for non-surgical methods or undergoing surgical procedures, every patient’s journey is guided by Dr Kirkham’s personalised care and dedication to achieving the best possible outcomes. If you think you may be suffering from Kienbock’s disease, get in touch with Dr Kirkham for an individualised solution that addresses your unique challenges and helps you regain your wrist’s health and functionality.

Prevention and Aftercare

To actively prevent Kienbock’s disease, a proactive approach must be taken by individuals that are at risk as a result of their age, occupation, or other factors. Minimising repetitive and excessive wrist motions, especially in occupations that demand constant wrist strain, can play a crucial role in reducing the likelihood of developing the condition. Ergonomic adjustments can also be important in maintaining the health of your wrist, with proper wrist alignment during strenuous activities being an important part of this process.

After undergoing treatment, diligent aftercare is essential to ensure a successful recovery. This often involves a tailored rehabilitation program designed to restore wrist strength, flexibility, and overall function. Physical therapy may encompass exercises to improve wrist mobility, gradually increasing in intensity to accommodate healing progress. Following post-operative guidelines and adhering to treatment plans contribute significantly to achieving optimal outcomes.

Equally vital is attending the regular follow-up appointments with Dr Kirkham, as this gives him the opportunity to assess and monitor the success of your recovery. If things aren’t progressing in the manner that was expected, adjustments can be made to prevent the condition from reoccurring and to ensure the patient fully recovers. These appointments also give patients a platform to raise concerns and suggest any adjustments to their treatment plan that they may feel are necessary. 

Incorporating these preventative measures, remaining committed to following aftercare instructions, and consistently attending follow-up appointments with Dr Kirkham are all important steps to take in managing Kienbock’s disease. By staying engaged in your wrist’s health journey and collaborating with experienced professionals, you can pave the way to a pain-free future.

The Recovery Process

The recovery process following a diagnosis of Kienbock’s disease revolves around a dynamic timeline that can be influenced by many different factors. Generally, the entire process can extend over several months, and in some cases, even longer. The early stages of recovery tend to involve rest, splinting, or immobilisation to allow the affected wrist to heal and reduce strain. During this phase, pain management and symptom alleviation are the primary focuses.

Factors that influence the recovery process include the disease’s stage at diagnosis, the chosen treatment method, and an individual’s overall health and adherence to their rehabilitation program. Naturally, surgical procedures might require a more extended recovery period than non-surgical approaches. If surgery has been completed, a more gradual return to wrist movement and strengthening exercises can be expected. Physical therapy may also be recommended, and closely following these programs and other post-operative guidelines can also impact the duration of the recovery process.

To assist his patients in their recovery, Dr Kirkham also provides a range of resources for reading and further exploration of the condition. Dr Kirkham also understands that the recovery process is never streamlined and is always dependent on the individual, making his personalised approach to recovery an important factor. Additionally, support from friends and family can empower individuals with knowledge and motivation to actively participate in their recovery.

The recovery process from Kienbock’s disease is a collaborative effort between Dr Kirkham, the patient, and their various support networks. By understanding the recovery timeline, recognising the factors that can influence the rehabilitation of the wrist, and tapping into available resources, patients can navigate each phase of healing with confidence and determination. The ultimate goal is a full return to a life unhindered by wrist discomfort, and with the help of Dr Kirkham, this is entirely achievable. 

Possible Complications

While Kienbock’s disease can be treated effectively, there are some potential complications that may be faced along the way. Common complications prior to treatment tend to include persistent pain, decreased wrist motion, and limited hand function. However, in advanced cases, arthritis might develop within the wrist joint due to altered mechanics, leading to additional discomfort and functional impairment. While less frequent, rare complications might involve complex regional pain syndrome or fractures of the adjacent bones. 

To prevent these complications and ensure a smooth recovery process is experienced, early diagnosis and a comprehensive treatment plan are crucial. Early intervention is always crucial, because many complications tend to arise develop when the disease has been left untreated for prolonged periods. Surgical procedures and rehabilitation play a pivotal role in preventing post-operative issues, such as stiffness or decreased wrist mobility. Whilst all surgical procedures carry their own risks, such as nerve damage or infection, the benefits far outweigh the potential drawbacks, which are also extremely rare.

Dr Kirkham’s expertise is also an important in factor in ensuring patients don’t encounter unwanted side effects that can worsen their condition. With his vigilant monitoring through regular follow-up appointments, complications can be detected early and managed effectively. His individualised approach to patient care extends beyond treatment, offering valuable insights and strategies to mitigate risks and foster a smooth recovery journey.

Managing Kienbock’s disease is a process that demands a great deal of commitment and consultation with Dr Kirkham, but it proves important in helping you steer clear of potential complications. By engaging with an experienced wrist surgeon like Dr Kirkham, you’ll be taking a proactive approach in maintaining your wrist function and comfort, helping you enjoy a pain-free lifestyle. Don’t let wrist pain and limited range of motion hold you back any longer. Get in contact with Dr Kirkham today for a consultation and keep your wrist health in check with a comprehensive assessment, diagnosis and treatment plan from a well-respected industry professional. 

Are You Concerned About Kienbock’s Disease?

If you find yourself with concerns about Kienbock’s disease, the best thing you can do is take a proactive approach and put your mind at ease. If you’re experiencing persistent wrist pain, discomfort, or tenderness, and if you’re struggling with limited grip strength and a reduced range of motion, don’t hesitate to reach out to Dr Kirkham today. His expertise is crucial in performing a thorough assessment of your wrist and providing you with an accurate diagnosis and explanation for the discomfort you’re experiencing.

Don’t let uncertainties linger – take that crucial step towards understanding your wrist health. Dr Kirkham’s vast experience has seen him assess, diagnose, treat and manage a wide range of wrist, hand, elbow and shoulder conditions, giving him the insight and wealth of knowledge you need to alleviate your pain. He always takes a personalised approach to recovery and treatment with each of his patients, giving them the clarity they need in their recovery process. Dr Kirkham is always ready to address any of your concerns and give you support and guidance to overcome the challenges you face and empower you to make informed decisions about your wrist health and well-being.

If you think you may have developed Kienbock’s disease, don’t suffer in silence any longer. Get in touch with Dr Kirkham to schedule a consultation at one of his five clinics across the Sydney region, and get started on your journey towards relief and renewed wrist vitality. Your wrist’s health is a priority, and seeking the professional guidance of Dr Kirkham is the first step towards regaining a comfortable and happy future free of wrist pain.


1. How rare is Kienbock’s disease?

Kienbock’s disease is considered relatively rare, affecting a small percentage of the population. Its rarity can be attributed to its specific set of causes and risk factors, including variations in wrist anatomy and blood supply patterns. While it may not be as prevalent as other wrist conditions, such as carpal tunnel syndrome, understanding its signs and symptoms is essential, especially for individuals at higher risk due to factors like age, gender, or occupation. Seeking medical attention for persistent wrist discomfort is crucial, as early diagnosis can lead to effective management and prevent potential complications down the line.


2. What happens if Kienbock’s disease is left untreated?

Leaving Kienbock’s disease untreated can lead to a progression of symptoms and potential complications. As the blood supply to the lunate bone diminishes, it can result in bone death (avascular necrosis), leading to pain, stiffness, and limited wrist mobility. Over time, this can cause adjacent bones to compensate for the loss of the lunate’s function, potentially resulting in altered wrist biomechanics and even the development of arthritis. In advanced cases, chronic pain and significant functional limitations may emerge, impacting daily activities and diminishing overall quality of life. Timely diagnosis and appropriate treatment, guided by experienced professionals like Dr Kirkham, can help mitigate these risks and provide effective solutions for managing the disease.


3. Can Kienbock’s disease affect both wrists?

Yes, Kienbock’s disease can potentially affect both wrists, although it is more commonly seen in one wrist. Factors such as genetics, occupation, and lifestyle can contribute to its occurrence. If you’re experiencing symptoms in both wrists or have concerns about wrist health, consulting a medical professional is essential for an accurate diagnosis and tailored guidance on the best course of action for your individual situation.


4. Are there any lifestyle modifications that can help manage Kienbock’s disease?

Yes, certain lifestyle modifications can help in the management of Kienbock’s disease. Avoiding activities that place excessive strain on the wrists, using ergonomic techniques during tasks, and maintaining a healthy lifestyle that supports bone and joint health can be beneficial. Adhering to post-treatment recommendations, such as physical therapy exercises and regular follow-up appointments, is crucial to achieving optimal outcomes. Consulting with healthcare professionals, like Dr Kirkham, can provide specific insights into lifestyle modifications that align with your condition and treatment plan.


5. Can Kienbock’s disease recur after treatment?

In some cases, Kienbock’s disease can recur after treatment, particularly if underlying risk factors or causes are not effectively addressed. Comprehensive treatment plans, tailored to each individual’s circumstances, play a vital role in reducing the risk of recurrence. Adhering to post-treatment guidelines, maintaining wrist health through ergonomic practices, and staying proactive with regular follow-up appointments can contribute to preventing recurrence. Dr Kirkham’s expertise ensures that treatment strategies take into account the factors that might lead to recurrence, offering a comprehensive approach to managing the disease effectively.


  1. OrthoInfo (Kienböck’s Disease)
  2. American Society for Surgery of the Hand (Kienbock’s Disease)
  3. Cleveland Clinic (Kienböck’s Disease)
  4. Massachusetts General Hospital (Kienbock’s Disease)