Review Question - QID 3649

The above patient was issued an intra-articular infusion of lidocaine for pain control after his surgery and may have developed shoulder chondrolysis. This complication after the use of intra-articular pumps has recently become more well known. The U.S. Federal drug and Administration (FDA) has issued a warning on the adminstration of continuous intra-articular infusion of local anesthestics for pain control.

The FDA has reviewed 35 cases of patients developing chondrolysis after intra-articular infusions, some being as early as 2 months after their surgery. The average time of diagnosis in these cases with chondrolysis were at an average of 8.5 months after the infusion. The majority of the reported cases occurred following shoulder surgeries. Joint pain, stiffness, and loss of motion were the most common physical complaints. As a result of their findings, the FDA issued a warning for surgeons to be aware and monitor for signs and symptoms of chondrolysis.

Illustration A shows a radiograph consistent with chondrolysis in a patient status post arthroscopic Bankart repair. This image shows the loss of joint height in the glenohumeral joint due to chondrolysis. Also, 2 suture anchors are visible as well in the glenoid from the Bankart repair. Illustration B shows an arthroscopic image of chondrolysis and Illustrations C and D demonstrate chondrolyis viewed from an open approach.