Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

The Food and Drug Administration (FDA) is notifying health care professionals of reports of a serious and destructive cartilage condition known as chondrolysis in patients who have had shoulder surgery during which they received continuously infused local anesthetics to deaden pain. The anesthetics were delivered via pain pumps, balloon-like devices that hold medication outside the body and have a catheter that delivers pain medication directly into the shoulder joint for up to 72 hours following surgery.

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Dr. David S. Bailie, an orthopedic surgeon in Scottsdale, Ariz., says he’s lost hours of sleep over a rare joint condition he started seeing far too often in his patients who had had arthroscopic shoulder surgery. “There’s nothing worse than a surgeon doing something that causes a problem, not fixes a problem,” he told the New York Times.

Since 2005, Dr. Bailie says he has seen dozens of patients come to him months after surgery with worsening pain and limited mobility. The diagnosis was chondrolysis, a condition in which the cartilage in the shoulder joint wears away leaving bone to rub against bone. There is no cure for chondrolysis and in some cases, total shoulder replacement is required.

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Whitney Moore was in prime physical condition just a few years ago. She played junior varsity soccer at West Virginia University before opening a strength and conditioning business for young athletes. In 2004, she injured her shoulder playing soccer and had surgery to repair it. But the surgery only made her shoulder worse. Moore developed a once-rare condition known as chondrolysis, in which the cartilage in the joint wears away causing bone to rub against bone.

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A statement released by Texas Longhorns trainer Kenny Boyd over the weekend clarifies quarterback Colt McCoy’s injury, which occurred Thursday, Jan. 7, during the BCS National Championship Game. According to the statement, McCoy wanted to get back in the game after being tackled by Alabama’s Marcell Dareus, but “we couldn’t clear him to do that,” Boyd says. McCoy suffered a pinched nerve in his shoulder, which didn’t cause pain but did make him lose feeling in his arm. Three attempts to complete a 7-yard pass to his father in the Texas locker room were all unsuccessful, which proved he could not return to the game.

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Patients who have had an orthopedic surgical procedure and received a prolonged infusion of a local anesthetic into the joint with a disposable elastomeric pump or any other infusion pump are urged by the Food and Drug Administration (FDA) to pay attention to symptoms of any joint pain, stiffness and decrease or loss of motion. If any of those symptoms persist, patients are advised to contact their health care professional.

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UCLA forward James Keefe will miss two to three weeks with the team to recovery from a dislocated left shoulder. The senior was injured during the first half of UCLA’s game against New Mexico State on December 15th. The injury occurred on the same shoulder that required surgery for a torn labrum in 2007.

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Characteristics of chondrolysis associated with intra-articular pain pumps after shoulder surgery was among the topics at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons/ the American Association of Orthopaedic Surgeons. The discussion included Drs. Peter Thomas Scheffel, Jeremiah Clinton, Joseph Lynch, Winston J. Warme, and Frederick A. Matsen III, and was moderated by Drs. Carl J. Basamania and Guido Marra. The message centered on the need for surgeons and patients to be aware of chondrolysis as a potential complication of the infusion of local anesthetic after shoulder arthroscopy.

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Jean-Thenistor Pascal, the Haitian-Quebecker professional boxer and current WBC Light Heavyweight Champion, underwent arthroscopic surgery on his right shoulder this week and will be unable to train or fight for about nine weeks. The boxer hurt his shoulder while successfully defending his title against Adrian Diaconu last week.

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Five lawsuits against manufacturers of pain pumps and pharmaceutical companies on behalf of 28 people were filed in Los Angeles County Superior Court this month, alleging fraud, breach of warranty and products liability, saying the makers of the products continued to market the pain pumps as mitigation for shoulder joints despite the specific use of those products not being approved by the Food and Drug Administration (FDA). The lawsuits also allege that the pain pump devices caused a painful and debilitating condition known as postarthroscopic glenohumeral chondrolysis (PAGCL), in which the cartilage in the shoulder joint wears away causing bone to rub against bone.

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The Food and Drug Administration (FDA) is warning orthopedic and anesthesia health care providers and hospital risk managers not to continuously infuse local anesthetics directly into the intra-articular joint space because this use of anesthetics has led to a painful and debilitating condition known as chondrolysis, or the decaying and destruction of the cartilage.

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