Reports of Cartilage Damage in Post-Surgery Anesthetic Patients

Dozens of patients given certain localized pain killers following surgery have developed chondrolysis, a condition marked by the destruction of articular cartilage in the shoulder or other joints, the Food and Drug Administration is warning.

In many cases, injured patients were forced to undergo subsequent joint replacement surgeries to correct the damage caused by the use of the pain drugs. The use of intra-articular pain pumps has been linked before to serious complications in post-surgery patients.

The FDA said today it has reviewed 35 reports of chondrolysis in patients given continuous intra-articular infusions of local anesthetics, including bupivacaine, chlorprocaine, lidocaine, mepivacaine, procaine, and ropivacaine. The drugs were administered with elastomeric infusion devices to control post-surgical pain and reports of cartilage injuries prompted the FDA to warn physicians and health care professionals of the risks.

“The significance of this injury to otherwise healthy young adults warrants notification to health care professionals,” the FDA said.

Extended Use of Pain Drugs Linked to Injuries

The injuries have occurred after the local anesthetics, given both with and without epinephrine, were infused to patients for between 48 and 72 hours, directly into the joint using an elastomeric pump, the FDA said.

On average, patients developed cartilage damage consistent with chondrolysis 8.5 months after the infusion, officials said. Patients also suffered joint stiffness and pain and reduced motion in the affected joint as early as two months after the infusion.

Nearly all the injuries occurred in patients who had undergone shoulder surgeries, the FDA said.

More than half of the injured patients who developed cartilage damage after the infusion of the pain drugs following surgery required arthroscopy or arthroplasty joint replacement surgeries to correct the problems.

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