Chondrolysis of the glenohumeral joint after infusion of bupivacaine through an intra-articular pain pump catheter: a report of 18 cases.

摘要: Purpose To report on our experience of patients who received infusion bupivacaine with epinephrine after arthroscopic glenoid labral repair surgery and in whom glenohumeral joint chondrolysis subsequently developed, as well to determine the incidence such surgeons' patient populations. Methods A retrospective chart review 18 diagnosed was carried out. All were from 2 experienced orthopaedic practices. Details their clinical course obtained summarized. These data compared all other arthroscopies completed by surgeons chondrolysis. Results postoperative through an intra-articular pain pump catheter (IAPPC). None thermal energy part procedure. had evidence infection, although extensive workup frequently undertaken. Clinically, presented a stiff, painful shoulder. Examination showed decreased range motion affected Radiographs magnetic resonance imaging space narrowing, subchondral sclerosis cyst formation. Of patients, 14 have since undergone repeat procedures, 5 humeral head–resurfacing operation. Within same time period, there 113 arthroscopies, 45 pumps used. Chondrolysis developed 16 32 high-flow IAPPCs 12 low-flow (1 patient's IAPPC flow rate not documented). Conclusions Although we cannot establish causal link, development may be related postoperatively. We thus caution against use IAPPCs. Level Evidence IV, therapeutic case series.