title: Risk factors for chondrolysis of the glenohumeral joint: a study of three hundred and seventy-five shoulder arthroscopic procedures in the practice of an individual community surgeon.
abstract: BACKGROUND
  Glenohumeral chondrolysis is a complication of arthroscopic shoulder surgery characterized by the dissolution of the articular cartilage of the glenoid and the humeral head. An analysis of 375 intra-articular shoulder arthroscopic surgical procedures by an individual community orthopaedic surgeon was performed to explore which factors or combinations of factors might be associated with glenohumeral chondrolysis.
  
  
  METHODS
  The occurrence of chondrolysis was correlated with several demographic and surgical variables with use of hazard ratios from Cox proportional hazards models and Kaplan-Meier survivorship curves. Sensitivity analysis was used to examine the effect of two different definitions of the date of the onset of chondrolysis.
  
  
  RESULTS
  In this cohort, each case of documented chondrolysis was associated with the intra-articular post-arthroscopic infusion of a local anesthetic, either Marcaine (bupivacaine) or lidocaine. In an analysis of the group that received an intra-articular postoperative infusion of a local anesthetic, the risk of chondrolysis was found to be greater for those with one or more suture anchors placed in the glenoid, for younger patients, and for those who had the surgery near the end of the ten-year study period.
  
  
  CONCLUSIONS
  To our knowledge, this is the first Level-II retrospective cohort study of the factors associated with the development of post-arthroscopic glenohumeral chondrolysis. In this cohort of intra-articular shoulder arthroscopic procedures, chondrolysis was observed only in cases in which either Marcaine or lidocaine had been infused into the joint during the postoperative period. Avoiding such a postoperative infusion may reduce the risk of chondrolysis.
authors.affiliation: University of Washington, Seattle, Washington, USA.
authors.forename: Brett P
authors.initials: BP
authors.lastname: Wiater
authors.forename: Moni Blazej
authors.initials: MB
authors.lastname: Neradilek
authors.forename: Nayak L
authors.initials: NL
authors.lastname: Polissar
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Matsen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects; D002357:Cartilage Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002358:Cartilage, Articular / Q000187:drug effects / Q000473:pathology*; D015331:Cohort Studies; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007260:Infusion Pumps; D007270:Injections, Intra-Articular; D007430:Intraoperative Care / Q000009:adverse effects / Q000379:methods; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
chemical_list: D002045:Bupivacaine; D004837:Epinephrine