Arthroscopic Resection of Symptomatic Bennett Lesions

Abstract

Bennett lesions, also known as "thrower's exostosis" of the shoulder, involve ossification of the posteroinferior glenoid and are not uncommon in overhead throwing athletes. The literature surrounding the optimal operative management of the symptomatic Bennett lesion is limited. The purpose of this article is to describe the arthroscopic surgical technique for the visualization and excision of the symptomatic extra-articular pathologic ossification involving the posteroinferior glenoid. Because many surgeons may not be familiar with this problem or procedure, we present a straightforward method that allows for identification and excision of the exostosis through an arthroscopic posterior arthrotomy.

Fig 1

Radiographic images of a Bennett lesion in the left shoulder of a high school pitcher. (A) Lateral view of Bennett lesion in posteroinferior region of glenoid (arrows). (B) An axillary view reveals the posterior exostosis (arrow).

Fig 2

Computed tomography image of a Bennett lesion in the left shoulder of a high school pitcher. An axial view shows the Bennett lesion in the posteroinferior aspect of the glenoid (arrows).

Fig 3

Arthroscopic images of a Bennett lesion excision in the left shoulder of a high school baseball pitcher. A 70° scope is within the anterior portal viewing posterior with the scope angled inferior. (A) Arthroscopic image of capsule adjacent to posterior and posteroinferior labrum prior to arthrotomy. (B) After capsulotomy, the glenoid neck exostosis is exposed, with the normal contour of the glenoid neck identified by arrows. (C) On completion of lesion dissection or excision, the contour of the glenoid neck (arrows) is restored.

Fig 4

Bennett lesion in the right shoulder of a collegiate baseball player. (A) Isolation of Bennett lesion (arrows) after arthrotomy. (B) Posteroinferior glenoid after completed resection of symptomatic Bennett lesion (arrows).