Glenoid osteochondritis dissecans in 9 baseball players: arthroscopic management and radiographic outcomes

Glenoid osteochondritis dissecans (OCD) is a rare condition seen occasionally in throwing athletes. Early diagnosis using conventional radiography is challenging. The aim of this study was to report on a series of baseball players receiving treatment for glenoid OCD. This retrospective case series included 9 baseball players with glenoid OCD who underwent arthroscopic surgery with a minimum of one-year follow-up. Plain radiographs were routinely obtained in the arm-elevated position (140-150°) to compare glenoid morphology between the throwing and non-throwing shoulders. Computed tomography and magnetic resonance imaging were used for definitive diagnosis and lesion assessment. Surgical procedures were selected based on intraoperative arthroscopic findings, including transarticular drilling for stable lesions and bone marrow stimulation for unstable lesions. The mean age at surgery was 16.6 ± 1.7 years, with a mean follow-up of 30.5 ± 12.7 months. All lesions were located in the posterior glenoid. Radiographic healing was confirmed on post-operative computed tomography at a mean of 12.0 ± 4.2 months, with no progression observed in any case. Eight of 9 patients (89%) successfully returned to play (RTP) at their preinjury competitive level at a mean of 9.2 ± 4.1 months post-operatively. Arm-elevated radiographs comparing both shoulders may serve as a useful adjunctive screening method for detecting glenoid OCD in throwing athletes. Arthroscopic treatment tailored to lesion stability was associated with a favorable RTP rate in this small case series; however, careful consideration of surgical timing is necessary.