Arthroscopic Microfracture for Focal Glenoid Osteochondral Lesions in Young Active-Duty Military Patients: A Minimum 10-Year Follow-Up

Background: Glenoid osteochondral defects (OCDs), while uncommon, are a recognized source of shoulder pain and dysfunction, particularly in young, active individuals. Arthroscopic microfracture (MFx) is a commonly used surgical option. However, long-term outcomes remain poorly defined. Purpose: To evaluate long-term clinical and functional outcomes after arthroscopic MFx for focal glenoid OCD in active-duty military patients. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review was conducted of 31 active-duty military patients ( .05). However, all patient-reported outcomes demonstrated statistically significant improvements: VAS (6.84 ± 1.92 to 2.52 ± 2.41), SANE (46.8 ± 20.1 to 81.1 ± 18), and ASES (51.1 ± 14.1 to 82.7 ±17) ( P < .0001 for all). At final follow-up, 68% (21/31) returned to sports and 78% (24/31) resumed unrestricted active military duty. Revision procedures were required in 4 patients (13%): 2 underwent total shoulder arthroplasty, and 2 underwent revision MFx with debridement. MRI detected OCD lesions in only 29% (9/31) of cases. Conclusion: Arthroscopic MFx offers durable pain relief and functional improvement for focal glenoid OCD with concomitant biceps tendinitis, subacromial bursitis, or partial RC tears in high-demand military patients. At a minimum 10-year follow-up, outcomes demonstrated sustained clinical benefits, high return to duty, moderate return to sports (RTS), and low revision rates. Limited MRI sensitivity and prolonged time to surgical treatment highlight the importance of early clinical suspicion and timely surgical intervention in this challenging population.