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

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.

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I-Flow has agreed to settle five lawsuits from plaintiffs who say the company’s pain pump device used during shoulder repair surgery caused them to develop a painful and debilitating condition known as chondrolysis. The announcement follows a ruling by a federal judge in Ohio who rejected efforts to have the cases dismissed. The lawsuits had been consolidated for a trial that was scheduled to begin late last month. All of the plaintiffs alleged that the pain pumps manufactured by I-Flow to infuse pain medication into the shoulder joint during and after arthroscopic surgery destroyed the shoulder cartilage, causing chondrolysis.

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Justin was just 17 years old when he was diagnosed with chondrolysis of his right shoulder. The condition occurs when the cartilage in the shoulder joint wears away causing bone to rub against bone. For more than a year, Justin suffered from such incredible pain that he was not able to use his right arm for even small tasks of everyday life, like combing his hair or putting on a shirt. The pain even kept him awake at night. But even more disappointing, Justin wasn’t able to compete as a swimmer, something he had participated in and trained for since he was just 7 years old.

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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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Matthew Beale of Portland, Oregon, routinely participated in football, racquetball and golf, and he enjoyed coaching his son’s baseball teams. But a minor tear in his bicep tendon caused by throwing a football benched the 38-year-old father of four. His doctor recommended routine arthroscopic surgery during which he was prescribed an I-Flow pain pump to deliver pain medication directly to the wound site for up to 72 hours.

However, the anesthetic that dripped from the pain pump into Beale’s shoulder joint killed the cells that create cartilage. Within months, Beale’s cartilage was completely destroyed, causing him so much pain he couldn’t shake his clients’ hands or even pick up his baby without a shockwave of pain. He now faces a complete shoulder replacement that doctors say will likely not permanently resolve his chronic pain or enable him to regain his active lifestyle.

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In light of a recent report released by the U. S. Food and Drug Administration that confirms the link between chondrolysis and pain pump use, Joseph A. Carrese, MD, MPH, an expert in bioethics, has issued an opinion stating that physicians have a responsiblity to inform former patients on whom they used the device of the possible risk.

It is Dr. Carrese’s opinion that “to do otherwise would be a failure of expected ethical and professional conduct, and in turn a failure of good clinical practice.”

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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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Deciding to have rotator cuff surgery can be trying decision. On one hand, it can relieve pain and increase mobility in the shoulder. But shoulder surgery can carry risks, some that may worsen the condition and may require more surgery. Before choosing to go under the knife, consider your options, says the e-zine Revolution Health.

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