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Arthroscopic Removal of Symptomatic Bennett Lesions in the Shoulders of Baseball Players: Arthroscopic Bennett-plasty

Minoru Yoneda, MD, PhD^*, Shigeto Nakagawa, MD, PhD^,, Kenji Hayashida, MD, PhD^*, Sunao Fukushima, MD^* and Shigeyuki Wakitani, MD, PhD^*

^* Shoulder and Sports Medicine Service, Osaka Kosei-nenkin Hospital, Osaka, Japan
Department of Orthopaedic Surgery, Osaka Prefectural Hospital, Osaka, Japan

Address correspondence and reprint requests to Shigeto Nakagawa, MD, PhD, Department of Orthopaedic Surgery, Osaka Prefectural Hospital, 3-1-56 Mandai-higashi, Sumiyoshi-ku, Osaka-shi, Osaka 558-8558, Japan

Background: Bennett lesions are often observed in throwing athletes, and, although usually asymptomatic, they can sometimes become painful and disturb an athlete’s throwing ability. Because it is clinically difficult to determine whether a Bennett lesion is symptomatic or whether pain is from another lesion, the outcome of surgical treatment is variable.

Hypothesis: Arthroscopic resection of Bennett lesions diagnosed according to our criteria and arthroscopic treatment of associated lesions performed simultaneously were effective for treatment of baseball players with symptomatic Bennett lesions.

Study Design: Prospective cohort study.

Methods: The following criteria for diagnosis of a symptomatic Bennett lesion were used to identify 16 baseball players who later underwent arthroscopic removal of the symptomatic Bennett lesion (arthroscopic Bennett-plasty): 1) detection of a bony spur at the posterior glenoid rim on radiographs; 2) posterior shoulder pain during throwing, especially in the follow-through phase; 3) tenderness at the posteroinferior aspect of the glenohumeral joint; and 4) relief of pain by injection of local anesthesia.

Results: After a minimum follow-up of 1 year, there was no tenderness at the posteroinferior aspect of the glenohumeral joint in any of the patients. Throwing pain disappeared in 10 shoulders and was mitigated in 6 shoulders. Eleven patients returned to baseball at their previous level of competition.

Conclusions: Accurate diagnosis and minimally invasive arthroscopic surgery are important for appropriate treatment of baseball players with symptomatic Bennett lesions.

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				R. W. Wright and G. A. Paletta Jr Prevalence of the Bennett Lesion of the Shoulder in Major League Pitchers Am. J. Sports Med., January 1, 2004; 32(1): 121 - 124. [Abstract] [Full Text]