ボクサーに発生した両側肩甲骨関節窩離断性骨軟骨炎の長期経過

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Osteochondritis dissecans (OCD) is a common disease in young active patients, which commonly develops in the capitellum of the humerus, medial condyle of the femur and the talus. We experienced a rare case of the OCD in bilateral glenoid in a boxer. A twenty-seven year old male presented in our hospital with bilateral shoulder pain. He has suffered right shoulder pain since sparring with a partner a year ago. Then he injured the left shoulder during a boxing practice. Shoulder pain with movement and no restriction of ranges of motion were observed at the first visit. The plain X-ray showed marginal irregularity of both glenoid. MR arthrography showed a low intensity area and irregularity of joint surface on the glenoid. We suspected OCD of both glenoid and performed arthroscopic surgery on both shoulders with an interval of 4 months between. We observed massive detachment of the cartilage of both glenoid, although the cartilage of the humeral head was intact. Arthroscopic debridement of the cartilage and micro fracture were performed. Postoperative X-ray showed progressive osteoarthritis of the shoulder joint at seven years after surgery. Joint reconstruction should be considered in a case of massive OCD in the glenoid.
日本肩関節学会の論文