“In people over the age of 70, pain is the main issue, and pain relief is a fairly reliable outcome after surgery,” said orthopedic surgeon Dr. Nikhil Verma, who led the study. “Patients do not require that their shoulder function be fully restored. They just want the pain to be gone.” Verma is assistant professor of orthopedic surgery at Rush.

Surgery of this type is often not advised for elderly patients because their circulation and bone quality is poorer. Many elderly also often have other diseases or condition that can compromise the healing process. However, arthroscopic surgery is far less invasive, leading to a more positive outcome.

The study looked at 39 patients over the age of 70 who underwent surgery to repair full-thickness tears in the rotator cuff after more conservative treatments, such as pain medication and procedures to remove fragments of tissue, had failed. The patients were followed for two years and their shoulder function was compared to that of similar seniors of similar age who had healthy, normal shoulders.

According to a press release issued by Rush, “Range of motion improved significantly. Patients were able to raise their arm in front and rotate it to the side – something that for many was difficult or impossible before the surgery. Muscle strength also improved. Pain was reduced significantly in 96 percent of the patients, many of whom had undergone the surgery because their pain was so bad they were unable to sleep. Almost all the patients reported improved function in their shoulder, and 94 percent said they were satisfied and would undergo the surgery again if they had to make the decision over.”

SOURCE: Pain Pumps › Elderly patients fare well after arthroscopic shoulder surgery

“We certainly knew that it was a possibility. We went through the rehab process in a very methodical way to give us the best chance to get him back on the mound, and it didn’t work,” executive vice president of baseball operations Andrew Friedman told USA Today. ”But in the meantime, we strengthened up the shoulder through the rehab process, which we feel like will aid in the recovery. And by all indications, (the surgery) went really well.” Howell is expected to recover in time to play during the 2011 season.

For some, however, shoulder surgery can exacerbate the injury. In the late 1990s, surgeons were told by the manufacturers of pain pumps that the devices could be used effectively in place of oral or IV painkillers. This reduced hospital stays and was to speed up the recovery process. However, doctors began seeing patients who underwent shoulder surgery but then developed a painful and debilitating condition known as chondrolysis in which the cartilage in the shoulder wears away causing bone to rub against bone.

It didn’t take long for doctors to realize that it was the pain pumps that were causing the chondrolysis. What was even more shocking is that the use of pain pumps in the manner in which pain pump manufacturers were telling doctors to do was never approved by the Food and Drug Administration (FDA). Last year, the FDA issued a notice to health care providers informing them that the pain pumps should not be used in shoulder surgery and that the use has never been approved.

SOURCE: Pain Pumps › Tampa Bay Rays’ Howell undergoes season-ending shoulder surgery

I-Flow had tried to prevent evidence from being included in the trial that would have been used to form the basis of punitive damage claims. That evidence allegedly included information that I-Flow’s chief executive officer was advised, prior to the plaintiffs’ injuries, to issue a warning that the pumps should not be used for shoulder surgery. Instead, I-Flow continued to instruct surgeons to use the pain pumps with local anesthetics for shoulder surgery, a use that was never approved by the Food and Drug Administration (FDA).

In November 2009, the FDA required manufacturers of pain pumps as well as the makers of local anesthetics used in the devices to add new warnings about the risk of chondrolysis. The warnings also alerted health care professionals not to use the pumps with local anesthetics.

There are at least 150 shoulder pain pump lawsuits pending against I-Flow and other manufacturers of pain pump devices from plaintiffs who allege that the devices caused them to develop chondrolysis of the shoulder. All lawsuits claim the manufacturers failed to warn patients and their doctors of the risk of chondrolysis.

SOURCE: Pain Pumps › I-Flow settles lawsuits from plaintiffs injured by shoulder pain pumps

Jean-Thenistor Pascal

Pascal said he dislocated his right shoulder three times during the fight and had to have his shoulder popped back into place at least once by one of his cornermen. Despite having to box stretches almost entirely with his left hand, and looking hurt and worn down in the last few rounds, Pascal prevailed, earning a unanimous victory from the judges.

“I know I have a lot of guts,” Pascal said after the fight. “I knew it and now I really know it. When it happened the first time I told myself I was finished, but I couldn’t pull out in front of these fans. No way was I going to quit.”

Pascal’s surgery involved the removal of a bone chip and repair to the shoulder labrum, according to a statement released by promoter Groupe Yvon Michel. Pascal has been ordered to rest his shoulder for three weeks followed by five or six weeks of rehabilitation before he will be allowed to resume normal training. Pascal is scheduled to meet the WBC interim champion Chad Dawson in 120 days, but he may need to postpone that meeting until his shoulder recuperates.

Shoulder repair surgeries are about 85-95 percent successful. But some patients have had lingering problems, including the developing of a painful and debilitation condition known as chondrolysis. It wasn’t until after 2000 that doctors began to make a connection between a type of chondrolysis known as Postarthroscopic Glenohumeral Chondrolysis and the use of intra-articular pain pumps used in surgery. Details of that discovery were later published by The American Journal of Sports Medicine, and numerous lawsuits from those who suffer from chondrolysis have since filed suit against the makers of pain pumps.

Source: Montreal Gazette

SOURCE: Pain Pumps › WBC boxing champ undergoes shoulder repair surgery

Shoulder injuries are not uncommon among athletes. Hard and repetitive throwing motions like those needed for football and baseball leave many players with shoulder problems, many of which require surgery. While a full recovery is usually possible, some patients’ injuries were worsened by shoulder surgery.

The phenomenon even confused doctors who performed the shoulder repair surgeries. They were finding a growing number of patients months or years after surgery were back in their offices complaining of pain, stiffness and loss of motion. Upon further inspection, doctors found those patients had developed a condition known as chondrolysis, caused by the breakdown of cartilage. As the cartilage wears away, bone begins to rub against bone causing even more pain and damage.

What doctors finally deduced was that it wasn’t the surgery that was causing this specific type of chondrolysis known as postarthroscopic glenohumeral chondrolysis (PAGCL), but the pain pump used during and after surgery. The pain pumps are devices that have a balloon filled with pain-deadening medication. That medication is fed directly into the wound site through a catheter for up to 72 hours.

The pumps were approved by the Food and Drug Administration (FDA) with the catheter placed in the shoulder tissue. But pain pump manufacturers began telling doctors to place the catheters in the shoulder joint, which allowed the joint space to be bathed in medication. What doctors didn’t realize is that constant drip of medication into the shoulder joint was slowly eating away at the cartilage, resulting in chondrolysis.

Since this discovery, published in a recent issue of The American Journal of Sports Medicine, patients who have suffered serious disability from the wrongful use of pain pumps have sued the manufacturers of pain pumps. If you are experiencing the symptoms associated with chondrolysis or PAGCL, you too may have a claim against the manufacturer.

Source: St. Petersburg Times

SOURCE: Pain Pumps › FSU quarterback faces shoulder repair surgery

“I think what we’re seeing is that physicians are finally seeing the relationship between pain pumps and chondrolysis – especially since the first lawsuits were filed a couple years ago,” he says. “In addition, literature is now being published about the connection between the pumps and chondrolysis. So, the more information that becomes available, the more people are learning what may be causing their shoulder problems.”

The problem traces back to about the year 2000, when pain pump manufacturers began advising physicians to place the device’s catheter into the joint space, or intra-articular area. The catheters were intended and approved by the Food and Drug Administration (FDA) to be placed into the shoulder tissue, and not the joint space. As a result, medicine was feeding directly into the joint space causing the cartilage to gradually wear away. This narrowing of the cartilage, called chondrolysis, causes severe pain and disability. There is no cure for the condition and many individuals are faced with lifelong disability as a result.

Recently, a study published by The American Journal of Sports Medicine identified intra-articular pain pumps as the likely cause of chondrolysis.

“People who had surgery seven or eight years ago who thought they had recovered are now seeing that they’re losing their cartilage and they don’t know why,” Woodson says, adding that several cases are set for trial in 2009. “I think that you’re going to see juries return verdicts against these defendants and then others will start to file lawsuits as well.”

SOURCE: Pain Pumps › More lawsuits filed as link made between pain pumps, chondrolysis