In a case of aseptic necrosis of the carpal lunate, a pathological examination of the excised bone showed extensive aseptic necrosis, collapse, and invasion (especially of the proximal portion) by vascular fibrous tissue. The articular cartilages were modified, and there were evidences through the bone of ununited fractures. In the wake of these changes, a secondary (degenerative) arthritis was developing. While in this case, a substantial portion of the lunate was affected, there are other cases in which the involvement is less widespread.
Excision is the treatment of choice, unless the lesion is small and limited to the proximal portion.