Lunate Excision and Interposition Arthroplasty Using Ipsilateral Palmaris Longus Tendon in Stage III b Kienböck’s Disease: A Case Report

Introduction: Kienböck’s disease is a rare, progressive condition characterized by avascular necrosis of the lunate bone, presenting clinically with wrist pain, reduced grip strength, and restricted motion. Early stages are amenable to conservative treatment, while advanced stages require surgical intervention. Case Presentation: We report the case of a 25-year-old female with Stage IIIb Kienböck’s disease of the left wrist. The patient underwent lunate excision and interposition arthroplasty using the ipsilateral palmaris longus tendon,which is redundant. Outcome: At nine-month follow-up, the patient exhibited significant improvement in pain and functional wrist motion, with the Visual Analog Scale (VAS) score improving from 8 to 2. Radiographs demonstrated maintained carpal alignment without evidence of collapse. Conclusion: Lunate excision and interposition arthroplasty using an autologous palmaris longus tendon can provide pain relief and preserve motion in selected patients with advanced Kienböck’s disease. However, this report is limited by the short follow-up period, and long-term studies are needed to confirm the durability of outcomes compared with other motion-preserving or salvage procedures.