The use of an intra-articular pump to control pain following orthopedic surgery may result in damage to the articular cartilage.
Chondrolysis is a result of damage to cartilage and results in a progressive narrowing of the joint space with pain and swelling.
Risk factors for chondrolysis associated with an intra-articular pain pump:
(1) injection of bupivacaine and possibly other local anesthetics within the intra-articular space
(2) use of higher concentrations of the local anesthetic
(3) prolonged exposure of the chondrocytes to the local anesthetic
Other causes of chondrolysis must be excluded:
(1) leakage of bone cement
(2) exposure to gentian violet
(3) use of radiofrequency energy during surgery
(4) chlorhexidine irrigation of the joint
The association between chondrolysis and the intra-articular pain pump may be missed if the onset of symptoms is months after surgery.
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