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

The Food and Drug Administration (FDA) has released safety tips for nurses on elastomeric infusion devices, or pain pumps, used during and up to 72 hours after surgery to deliver a continuous amount of local anesthetic directly into the patient’s intra-articular space, or shoulder joint, for postoperative pain control. The FDA has received approximately 35 reports of chondrolysis in patients who received continuous intra-articular infusions with pain pump devices. This type of chondrolysis, called postarthroscopic glenhumeral chondrolysis (PAGCL), occurs when the shoulder cartilage is worn away, causing bone to rub against bone. It is a severe, life-altering complication that is usually irreversible. Many patients require a total shoulder replacement.

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Much has been reported lately about chondrolysis of the shoulder, or Postarthroscopic Glenohumeral Chondrolysis (PAGCL). So what is chondrolysis and why is it getting so much face time? Chondrolysis is the destruction of the cartilage in a joint. It is generally a rare condition anywhere in the body, but it has been most often heard of in hip joints most often from birth defects. Before the 1990s, chondrolysis in the shoulder was never seen.

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Patients who used pain pump devices to relieve pain from shoulder surgery are at risk for permanent joint damage, according to recent studies. Pain pumps are balloon-like devices that are filled with anesthetics that deliver medication directly into the surgical space via a catheter. The medication is slowly released into the joint space for up to 72 hours following surgery and then the catheter is removed by the patient.

While this use of pain pumps was a convenient way to relieve pain from surgery, it also resulted in a surprisingly high number of cases of a painful and debilitating deterioration of cartilage in the shoulder joint known as chondrolysis, specifically Postarthroscopic Glenhumeral Chondrolysis (PAGCL). The condition is permanent and many who suffer from it require shoulder replacement surgery.

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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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Things were looking promising for Florida State University quarterback Christian Ponder, until last Saturday, when he separated his right shoulder making a tackle after throwing his fourth interception against Clemson. He now faces surgery to repair a Grade 3 AC separation, which will bench him for the rest of the season.

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I-Flow Corp., the Irvine, Calif.-based device maker, exceeded expectations with its quarterly results and says it expects to see an operating profit for the year despite a sharp increase in the number of product liability lawsuits filed against the company in July 2009. The company, which makes devices that deliver targeted anesthesia as an alternative to narcotics known as pain pumps, has a market value of $175 million.

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The shoulder joint has the greatest range of motion of all our joints and allows us to use our arms for various tasks, from throwing pitches to supporting our bodies. When the shoulder is injured, surgery may be required to relieve pain and restore mobility. However, some individuals have found that surgery on their shoulder has made their condition worse.

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Pain pumps are devices designed to deliver medication directly into the surgical site to manage pan after surgery. While effective for pain management, physicians began seeing more and more patients suffering from a debilitating condition known as chondrolysis following use of shoulder pain pumps. This concern was validated in a recent study by The American Journal of Sports Medicine, which identified a specific type of chondrolysis, Postarthroscopic Glenohumeral Chondrolysis (PAGCL), associated with the use of shoulder pain pumps. As a result, hundreds of people harmed by the devices have filed suit against the manufacturers of pain pumps.

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Just five years ago, baseball writer, radio host and injury expert Will Carroll called torn shoulder labrums “baseball’s most fearsome injury,” adding “If pitchers with torn labrums were horses, they’d be destroyed.” However, thanks to improvements in surgery, baseball players no longer have to look at torn labrums as career-ending injuries.

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Two studies show that knee surgery is beneficial at times but should not be performed routinely for the treatment of osteoarthritis, according to Fox News. The studies were published in a recent New England Journal of Medicine. One finds that medicine combined with physical therapy is just as effective as surgery for relieving the pain and stiffness of moderate or severe arthritis. The other study finds that tears in knee cartilage that often result in surgery are very common and do not always cause symptoms.

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