Postarthroscopic glenohumeral chondrolysis.
Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication in which the articular cartilage of the shoulder undergoes rapid, degenerative changes shortly after arthroscopic surgery. Patients with PAGCL are often young (eg, aged 10 to 40 years) and develop deep shoulder pain with progressive loss of motion that begins months after the initial arthroscopic surgery. PAGCL should be considered in the differential diagnosis in the patient with deep, unexplained shoulder pain following arthroscopic surgery. Although the etiology of PAGCL is not yet fully understood, the pathophysiology is likely multifactorial. Inherent patient factors and risk factors for PAGCL have been identified, but it is unclear how these factors interact. Current surgical practices need to be examined and new practices developed to prevent PAGCL. Proud placement of nonabsorbable suture anchors during surgery to correct instability, as well as the use of thermal devices and intra-articular pain pumps, should be avoided.
Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, USA.
Peter C
PC
Yeh
F Daniel
FD
Kharrazi
D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy / Q000009:adverse effects*; D002358:Cartilage, Articular / Q000473:pathology*; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D017746:Joint Capsule / Q000473:pathology; D010149:Postoperative Pain / Q000517:prevention & control; D012307:Risk Factors; D012785:Shoulder Joint; D020069:Shoulder Pain / Q000209:etiology; D053441:Suture Anchors; D007507:Therapeutic Irrigation
D000779:Anesthetics, Local; D004837:Epinephrine