Glenohumeral chondrolysis: a systematic review of 100 cases from the English language literature.
OBJECTIVE
Chondrolysis can be a devastating complication of shoulder arthroscopy. We undertook a review of the 100 cases reported in the English language to test the hypothesis that common factors could be identified and that the identification of these factors could suggest strategies for avoiding this complication.


METHODS
We systematically reviewed the English language literature and identified 16 articles reporting 100 shoulders in which postsurgical glenohumeral chondrolysis had developed.


RESULTS
The average reported patient age was 27 +/- 11 years at the time of surgery; 35 were women. The most common indications for surgery were instability (n = 68) and superior labrum anteroposterior lesions (n = 17). In 59 cases, chondrolysis was reported to be associated with the use of intra-articular pain pumps. The infusate was known to include bupivacaine in 50 shoulders and lidocaine in 2. Radiofrequency capsulorrhaphy was performed in 2 shoulders.


CONCLUSIONS
Fifty-nine percent of the reported cases of glenohumeral chondrolysis occurred with the combination of arthroscopic surgery and postarthroscopy infusion of local anesthetic. The arthroscopic operations observed with chondrolysis were not limited to stabilization procedures, and the infused anesthetic was not limited to bupivacaine.


CONCLUSIONS
In that postoperative infusion of local anesthetic and radiofrequency may not be essential to the success of shoulder arthroscopy, surgeons may wish to consider the possible risks of their use.
Scheffel
Peter T
PT
Department of Orthopedics and Sports Medicine, University of Washington Medical Center, Seattle, WA 98195, USA.
Clinton
Jeremiah
J
Lynch
Joseph R
JR
Warme
Winston J
WJ
Bertelsen
Alexander L
AL
Matsen
Frederick A
FA
D001182:Arthroscopy / Q000379:methods*; D002357:Cartilage Diseases / Q000175:diagnosis / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology* / Q000601:surgery; D006801:Humans; D012785:Shoulder Joint