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Pain pumps likely cause of shoulder chondrolysis
July 28th, 2010 by Jennifer Walker-Journey
Postarthroscopic glenohumeral chondrolysis, or chondrolysis of the shoulder, was once unheard of, but surgeons are beginning to see the debilitating condition affect more and more patients who have previously had shoulder surgery, according to Ortho Super Site. Chondrolysis occurs when the cartilage in the shoulder wears away causing bone to rub against bone. Symptoms of chondrolysis often present between three and 12 months after shoulder surgery and begin as a deep ache that progresses to severe pain and loss of motion. While the cause of chondrolysis is still up for debate, one likely culprit is the use of intra-articular pain pumps during the shoulder surgery.
Pain pumps are balloon-like devices that are filled with anesthetic and rest outside the body. During surgery, a catheter from the pain pump is placed inside the surgical site and delivers pain medication directly to the joint space. This use of pain pumps in shoulder surgery became popular in the 1990s after manufacturers instructed surgeons to use the pumps in this manner. However, this use was never approved by the Food and Drug Administration (FDA), and soon complications began to arise.
Doctors were baffled at first to see so many former shoulder surgery patients coming back with even more pain than before. It didn’t take long for doctors to make a connection between pain pumps, anesthetics and debilitating shoulder chondrolysis. One likely theory is that the anesthetic delivered directly to the shoulder joint caused the cartilage to wear away in many people.
Treatment for chondrolysis is challenging, says Ortho Super Site. Nonsteroidal anti-inflammatory drugs, intra-articular corticosteroids, and hyaluronic acid may provide some relief but ultimately, most sufferers may need total shoulder replacement surgery.
