Saturday, February 18, 2012

Postarthroscopic Glenohumeral Chondrolysis PAGCL JAAOS

The February 2012 JAAOS published an article on Postarthroscopic Glenohumeral Chondrolysis. This article points out, once again, that glenohumeral chondrolysis is the devastating and irreversible destruction of the articular cartilage of the shoulder joint, often in young (average age in the late 20's) active individuals having shoulder arthroscopy for the treatment of non-degenerative conditions, such as instability or 'SLAP' tears. In that once it has been initiated, the destruction of cartilage cannot be stopped or reversed, it is essential that the causes of chondrolysis be identified so that the condition can be prevented by avoiding each of the causational factors. As we have described in a previous post the evidence linking pain pumps to the irreversible destruction of articular cartilage from chondroysis is clear.

Against this background it is curious that the authors state that 'no cause of PAGCL has been confirmed and the associations are mostly speculative'. We note that one of the authors of this article discloses that he or an immediate family member serves as a paid consultant to Styker, a manufacturer of pain pumps used for the post arthroscopic infusion of local anesthetics.

The authors borrow photographs from a recent article, Risk Factors for Chondrolysis of the Glenohumeral Joint, A study of 375 shoulder arthroscopic procedures in the practice of an individual community surgeon. This article clearly demonstrates the role of post-arthroscopic infusion of local anesthetics via pain pumps in the causation of glenohumeral chondrolysis, yet they omit this article from their discussion of the causes of this condition.

The causation of chondrolysis is now clearly established as shown in this post.


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