Case reports: two cases of glenohumeral chondrolysis after intraarticular pain pumps.
BACKGROUND
Acute idiopathic chondrolysis in young adults is rare. The etiology often is unknown and outcomes can be devastating owing to rapid development of painful secondary osteoarthritis. There have been some recent reports of chondrolysis after arthroscopic shoulder procedures. Animal and laboratory data suggest chondrolysis is related to the use of intraarticular pain pumps, although there is no conclusive evidence that this is causative in patients.


METHODS
We present two cases of young adults with chondrolysis of the humeral head after intraarticular pain pump use with humeral head resurfacing and biologic glenoid resurfacing.


METHODS
Several authors report glenohumeral chondrolysis after shoulder arthroscopy involving the use of bupivacaine pain pumps. In addition, experimental animal studies have confirmed the presence of chondrolysis after bupivacaine infusion.


CONCLUSIONS
These cases provide additional evidence of an important association between postarthroscopic chondrolysis of the glenohumeral joint and the use of bupivacaine pain pumps.
Anakwenze
Okechukwu A
OA
Department of Orthopaedic Surgery, The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Hosalkar
Harish
H
Huffman
G Russell
GR
D000328:Adult; D000698:Analgesia / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D001182:Arthroscopy / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D002357:Cartilage Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D002358:Cartilage, Articular / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D008279:Magnetic Resonance Imaging; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
D000779:Anesthetics, Local; D002045:Bupivacaine