Abhinav Gulihar1, Shibby Robati2, Haider Twaij3, Alan Salih2, Grahame J S Taylor4. 1. Trauma and Orthopaedics, Dartford and Gravesham NHS Trust, UK. 2. Trauma and Orthopaedics, East Sussex Hospitals, UK. 3. St. Mary's Hospital, London W2 1NY, UK. 4. Leicester General Hospital, Leicester LE5 4PW, UK.
Abstract
BACKGROUND: Chondrolysis involves the breakdown of cartilage following arthroscopic surgery, most commonly affecting the glenohumeral joint. METHODS: This review summarises all clinical and laboratory studies regarding local anaesthetic (LA) and its association with chondrolysis. We identified 289 papers, 41 of which met our inclusion criteria and were included in the final review. RESULTS: Bupivacaine, lidocaine, ropivacaine and levobupivacaine are all toxic to cartilage. Intra-articular infusions confer a greater toxicity to cartilage than single injections. CONCLUSIONS: Intra-articular LA pain pumps carry a high risk of chondrolysis and should be avoided. Further studies are indicated to assess long-term single exposure LA implications.
BACKGROUND: Chondrolysis involves the breakdown of cartilage following arthroscopic surgery, most commonly affecting the glenohumeral joint. METHODS: This review summarises all clinical and laboratory studies regarding local anaesthetic (LA) and its association with chondrolysis. We identified 289 papers, 41 of which met our inclusion criteria and were included in the final review. RESULTS:Bupivacaine, lidocaine, ropivacaine and levobupivacaine are all toxic to cartilage. Intra-articular infusions confer a greater toxicity to cartilage than single injections. CONCLUSIONS: Intra-articular LA pain pumps carry a high risk of chondrolysis and should be avoided. Further studies are indicated to assess long-term single exposure LA implications.
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