Postarthroscopic glenohumeral chondrolysis explained

Specialty:	orthopedic
Risks:	Complication of arthroscopic surgery

Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication of arthroscopic surgery and involves chondrolysis wherein the articular cartilage of the shoulder undergoes rapid, degenerative changes shortly after arthroscopic surgery.^[1]

Causes

Bupivacaine, lidocaine, ropivacaine and levobupivacaine are all toxic to cartilage and their intra-articular infusions can lead to this toxic effect.^[2] Intra-articular pain pumps with local anesthetics have been implicated as a potential cause.^[3]

Treatment

Total Joint Arthroplasty or reverse total joint arthroplasty (shoulder replacement surgery)

Notes and References

1. Yeh. PC. Kharrazi. FD. Postarthroscopic glenohumeral chondrolysis.. The Journal of the American Academy of Orthopaedic Surgeons. February 2012. 20. 2. 102–12. 10.5435/JAAOS-20-02-102. 22302448. 11304366.
2. Gulihar. Abhinav. Robati. Shibby. Twaij. Haider. Salih. Alan. Taylor. Grahame J.S.. Articular cartilage and local anaesthetic: A systematic review of the current literature. Journal of Orthopaedics. December 2015. 12. Suppl 2. S200–S210. 10.1016/j.jor.2015.10.005. 27047224. 4796530.
3. Busfield. Benjamin T.. Romero. Denise M.. Korshad. Daniel. Kharrazi. F. Daniel. Subacromial pain pump use is safe after arthroscopic rotator cuff repair. Journal of Orthopaedics. June 2014. 11. 2. 64–67. 10.1016/j.jor.2014.04.012. 25104887. 4118566.