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.


To read more or access our algorithms and calculators, please log in or register.