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.

SOURCE: Pain Pumps › Pain pumps likely cause of shoulder chondrolysis

Shoulder chondrolysis is a condition that more and more people who have had previous shoulder repair surgery have been diagnosed with. It was the surgeons who first realized that what caused these patients to develop the serious shoulder ailment was the pain pump device used during and after surgery to deaden pain in the shoulder joint. Doctors later learned that pain pump manufacturers were instructing surgeons to use the devices in a manner that was not approved by the Food and Drug Administration (FDA). Unfortunately, there is no cure for chondrolysis and many patients who suffer from the condition must undergo shoulder replacement surgery.

For Justin, relief came in November 2008, when he had a humeral head transplant. The surgery was performed by Dr. Brian Cole with The Cartilage Restoration Center at Rush. Since then, Justin’s right arm mobility has been restored and he is back to living an active lifestyle.

Source: Life Active with Rush

SOURCE: Pain Pumps › Chondrolysis sufferer finds relief with humeral head transplant

But Smith’s doctor, Bryan Wall, an orthopedic surgeon at the Core Institute of Phoenix, Ariz., wasn’t giving up. He suggested Smith have a new procedure, a reverse shoulder replacement. Approved by the Food and Drug Administration (FDA) in 2004, the procedure offers relief to some patients who suffer long-term rotator cuff tears with arthritis. During the procedure, surgeons place an implant in the shoulder that is designed so that the ball portion of the shoulder is attached directly to the shoulder blade. The socket is then placed at the upper end of the arm bone. The procedure essentially reverses the anatomy of the shoulder.

“What it does is it allows us to not only replace the joint that has become arthritic, but it puts the shoulder in a better mechanical position and changes the mechanics of the shoulder to allow people to elevate their arm,” Dr. Wall explained.

The result was life-changing for Smith, who said he no longer has pain in his right arm and is able to get on with an active retirement. However, Dr. Wall warns, the procedure is not recommended for all patients. The best recipients are older patients who are less likely to put extreme stress on the shoulder joint.

SOURCE: Pain Pumps › New procedure may prove effective for some shoulder injuries

“When you lose someone like that,” Hillman said to The Kansas City Star, “it’s tough to replace. We tried to protect it, and we rested him a couple of times, but it’s just one of those things that needs to be repaired.”

The surgery will end the season prematurely for Crisp, but it shouldn’t hamper his chances for a full recovery. But for hundreds of individuals who had surgery for repairs like a torn labrum in the shoulder, the pain treatment turned out to be more painful and debilitating than the torn labrum itself.

The problem traced back to a pain pump device that is designed to deliver pain medication directly into the shoulder tissue for up to 72 hours following surgery. With the catheter placed in the shoulder tissue, the pumps were effective.

However, in the early 2000s, pain pump manufacturers advised surgeons to place the catheter in the shoulder joint. As the pain medication dripped into the joint rather than the tissue, it began eating away at the shoulder cartilage. The result was a painful condition known as chondrolysis, or specifically Postarthroscopic Glenohumeral Chondrolysis. The condition has caused greater disability and in some cases, shoulder replacement surgery was required.

Hundreds of lawsuits have since been filed against manufacturers of the pain pumps. Patients who have used a pain pump to regulate pain following shoulder, knee, hip, ankle or back surgery, should consult their doctor if they experience continued pain; weakness in the shoulder; clicking, popping or grinding in the shoulder; or a decreased range of motion. Individuals who have been injured by an intra-articular pain pump may have a claim against the manufacturers.

SOURCE: Pain Pumps › Coco Crisp to undergo season-ending shoulder surgery