Osteochondritis dissecans of the glenoid: A case report and review of the literature.

BACKGROUND: Osteochondritis dissecans (OCD) is an articular disorder characterized by focal subchondral bone involvement that may progress to cartilage instability and fragment detachment. Although OCD most commonly affects the knee, ankle, and elbow, shoulder involvement is rare, and glenoid lesions are particularly uncommon. The limited literature consists primarily of isolated case reports, most frequently describing male overhead athletes. Optimal management strategies for glenoid OCD remain poorly defined, particularly in adolescent athletes with big chondral lesions. PURPOSE: To report a rare case of an International Cartilage Regeneration & Joint Preservation Society (ICRS) grade III OCD-like glenoid subchondral lesion with a large unstable overlying chondral flap in a 16-year-old competitive female softball athlete who failed conservative management and to describe the arthroscopic surgical approach utilized for cartilage preservation. CONCLUSION AND CLINICAL RELEVANCE: OCD-spectrum lesions of the glenoid are an uncommon condition that can occur in adolescent female overhead athletes. In cases of unstable lesions that remain viable and fail nonoperative treatment, surgical management aimed at preserving native cartilage and restoring articular congruity may represent a feasible cartilage-preserving treatment strategy. This case contributes to the limited body of literature on glenoid OCD and supports individualized, cartilage-preserving approaches in high-demand adolescent athletes.