Posterior shoulder pain in throwing athletes with a Bennett lesion: Factors that influence throwing pain

Nakagawa, Shigeto; Yoneda, Minoru; Hayashida, Kenji; Mizuno, Naoko; Yamada, Shinichi

doi:10.1016/j.jse.2005.05.010

Cited by 28 publications

(11 citation statements)

References 11 publications

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“…In 1999, Meister et al [13] reported on the ''thrower's exostosis,'' considering the inferior ossification as the result of traction on the retracted posteroinferior capsule. Others reported posterosuperior osteophytes [15,19]. Despite a precise analysis of these publications, we are unable to state whether the ossifications we describe in our study are different from the so-called Bennett lesions or the same entity viewed with different types of radiographs.…”

Section: Discussioncontrasting

confidence: 74%

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Lévigne¹,

Garret²,

Grosclaude³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports. In 1996, we proposed adding abrasion of the bony posterior rim, or glenoidplasty.

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Section: Discussioncontrasting

confidence: 74%

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Lévigne¹,

Garret²,

Grosclaude³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Bennett 4 first described a “posteroinferior bone deposit on or about the triceps resulting from an abnormal strain on the tendon.” Similar descriptions of posteroinferior exostoses were reported by Lombardo et al 20 and Meister et al 22 The exostosis has since been reported to be both subperiosteal attached to the glenoid and a free bony fragment. 2 , 25 Subperiosteal lesions have similarly been reported at the long head of the muscle origin. 4 , 28 …”

Section: Resultsmentioning

confidence: 91%

“…Meister et al 23 found gains in external rotation and loss of internal rotation for all 22 athletes in their series. Nakagawa et al 25 reported a GIRD of only 10° in 31% of the group who had a painful classic Bennett lesion and in 73% of asymptomatic patients who had a classic Bennett lesion. Full symmetric motion was observed in the 3 patients with pitcher’s mound lesions reported by Pearce and Burkhart.…”

Section: Resultsmentioning

confidence: 99%

“… 10 , 20 , 23 The location of the lesion is the region of attachment on the posterior band of the inferior glenohumeral ligament. 27 Of the 23 (85%) articles found on Bennett lesions, 15 articles 1 - 6 , 8 , 10 , 12 , 13 , 20 , 24 , 25 , 28 , 36 described the lesion in this posteroinferior position ( Table 1 ). Debatably, the repetitive stresses of throwing potentially serve as the stimulus for the reactive changes in the posterior capsule.…”

Section: Resultsmentioning

confidence: 99%

“…Certain throwers may report pain throughout the throwing cycle, which confounds the history. 22 , 28 Pain during the follow-through phase is associated with the classic Bennett lesion, 4 , 25 whereas pain with late cocking and early acceleration is found with posterosuperior exostosis. 24 Walch et al 33 described the pathological contact of the posterosuperior glenoid (labrum) and the articular-sided rotator cuff and greater tuberosity during late cocking, known as internal impingement, which may accentuate the pain of a posterosuperior lesion.…”

Section: Resultsmentioning

confidence: 99%

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Thrower’s Exostosis of the Shoulder: A Systematic Review With a Novel Classification

Freehill

Mannava

Higgins

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: A variety of thrower’s exostoses are grouped under the term Bennett lesion, which makes understanding diagnosis and treatment difficult. Purpose: To identify all types of reported thrower’s and overhead athlete’s exostoses and categorize them into a classification system to allow a morphology-based classification. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of all articles pertaining to Bennett lesions and thrower’s exostosis was performed. The classification and treatments were evaluated to describe the types, proposed causes, diagnosis, and treatment options. Results: A total of 27 studies were included in the systematic review. The anatomic locations referenced in the study demonstrated posteroinferior, posterior, and posterosuperior glenoid lesions. Aggregate radiographic data demonstrated 158 of 306 patients (52%) with a thrower’s exostosis of any type and location. Of these 158 patients with a radiographic lesion, 119 (75%) patients were symptomatic. The locations were posteroinferior in 110 patients (70%), directly posterior in 2 patients (1.3%), posterosuperior in 44 patients (28%), and unknown in 2 patients (1.3%). Avulsed lesions were present in 9 (5.7%) posteroinferior lesions, 0 direct posterior lesions, and 2 (1.3%) posterosuperior lesions. Treatment plans included both nonoperative and operative strategies, but operative intervention was more commonly reported for detached lesions. After operative intervention, only 61% of reported athletes returned to preinjury performance. Conclusion: Based on a comprehensive review of the literature, we identified several anatomic locations for a thrower’s exostosis beyond the classic Bennett lesion. We categorized the reported exostoses into a new classification system for description of location and type (subperiosteal or free fragment) of the thrower’s exostosis, which may be used to study future treatments. Current treatment strategies recommend that surgical treatment of thrower’s exostosis is considered only after exhausting nonoperative management because reported return to sport is variable after surgery. The effectiveness of excision or repair for both subperiosteal and detached lesions has not been established.

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Prevalence of Bennett lesions based on sex, ancestry, and age in an osteologic collection of 5,662 scapulae

et al. 2020

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BackgroundBennett lesions represent an extra‐articular ossification on the posteroinferior aspect of the glenoid fossa and a potential source of posterior shoulder pain and limitation. The prevalence of Bennett lesions in the general population is unknown.Materials and methodsA total of 5,662 scapulae from 2,831 individual cadaveric specimens greater than 18 years of age at the time of death were examined. Matching scapulae were evaluated for Bennett lesions by two independent authors. Lesion prevalence was calculated and statistical analysis performed to evaluate differences in prevalence based on specimen sex (males vs. females), ancestry (African‐American vs. Caucasian) and with increasing age at the time of death.ResultsBennett lesions were observed in 3.5% (n = 98 of 2,831) of specimens and 1.8% (n = 104 of 5,662) of scapulae. Interobserver reliability was 0.83, indicating excellent agreement among authors. Males possessed significant higher odds of possessing a Bennett lesion when compared to females (p = .009) and African‐American specimens when compared to Caucasian specimens (p < .001). Each additional year of age was associated with a 1.4% increase in odds of a specimen having a Bennett lesion, while no significant increase in Bennett lesion prevalence was appreciated with increasing specimen age at the time of death when comparing male to female specimens (p = .07) or African‐American to Caucasian specimens (p = .73).ConclusionsBennett lesions were identified in 3.5% of osseous specimens and 1.8% of scapulae, with significantly higher prevalence in male and African‐American specimens.

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Posterior shoulder pain in throwing athletes with a Bennett lesion: Factors that influence throwing pain

Cited by 28 publications

References 11 publications

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Thrower’s Exostosis of the Shoulder: A Systematic Review With a Novel Classification

Prevalence of Bennett lesions based on sex, ancestry, and age in an osteologic collection of 5,662 scapulae

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