Avascular Necrosis of the Lunate

Definition and Terminology

• Osteonecrosis (bone death due to inadequate vascular supply) is sometimes called "avascular necrosis" or "aseptic necrosis" when involving epiphyseal locations like the lunate bone 1, 2
• The lunate is one of the common sites for osteonecrosis, along with the femoral head, humeral head, scaphoid, and talus 1, 2

Pathophysiology

• Three possible mechanisms have been proposed for osteonecrosis/avascular necrosis:

Risk Factors

• Risk factors for osteonecrosis in general include:
  • Corticosteroid therapy 4
  • Alcohol use 4
  • Blood dyscrasias 1
  • Prior dialysis in transplant patients 4

Clinical Implications

• Secondary osteoarthritis can occur as a result of avascular necrosis of the lunate 1, 3