Treatment of Kienböck's disease encompasses a wide array of options. Proper staging is the first step to successful treatment. Revascularization of the lunate remains a viable option for the treatment of Lichtman stage II or IIIA Kienböck's disease. In this article, we review the indications for and the surgical technique used with a modified Hori procedure (vascular pedicle insertion with structural distal radius graft) for revascularization of the lunate.