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 nine 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 (CT) and magnetic resonance imaging (MRI) were used for definitive diagnosis and lesion assessment. Surgical procedures were selected based on intraoperative arthroscopic findings, including trans-articular 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 postoperative CT at a mean of 12.0 ± 4.2 months, with no progression observed in any case. Eight of nine patients (89%) successfully returned to play (RTP) at their preinjury competitive level at a mean of 9.2 ± 4.1 months postoperatively. 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.