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SHOULDER PAIN PUMP
by Jane Mundy
Often at the end of shoulder surgery, a temporary catheter (an easily removed, small and flexible plastic tube) is inserted by the surgeon into the shoulder joint and left for a few days after surgery to deliver pain medication to that area. The pump is designed to deliver fast pain relief but for some patients, a shoulder pain pump creates even more pain and injury.
Studies reveal that it is potentially dangerous when used in the shoulder joint space and shoulder injury patients who used the pain pump have developed Postarthroscopic Glenohumeral Chondrolysis (PAGCL), which is a progressive loss of cartilage of the glenohumeral joint—the joint that joins the arm and shoulder. The head of the arm bone, which connects to the joint, is covered in articular cartilage, which allows the shoulder joint to move smoothly. If this cartilage is damaged or destroyed, the shoulder cannot move easily, causing significant pain and reduced range of motion. In extreme cases, irreparable damage occurs and the patient loses the ability to use the shoulder.
In 2006, the American Journal of Sports Medicine reported that post-operative pain pumps are the likely cause of a condition called chondrolysis, also known as PAGCL.
In the same year, The American Academy of Orthopedic Surgeons also reported that the use of these pain pumps may be associated with PAGCL. Medical charts of 152 patients who had undergone anthroscopic shoulder surgeries were studied and 12 of the patients developed PAGCL--all of whom had received pain pumps during their surgeries. The use of the shoulder pain pump was the only factor that the PAGCL patients had in common.
Recently, orthopedic surgeon Dr. Charles Beck co-authored an article stating that these devices can cause permanent and debilitating damage to the shoulder. Thousands of patients have used these devices, but Dr. Beck says that "hundreds appear to be at risk for this complication which results in severe pain, debilitating stiffness and eventual joint replacement surgery for many of those affected." This defective product is a particularly troubling development since many shoulder injuries are sports-related: many active and young individuals could be affected for the rest of their lives.
The results of Dr. Beck's study have not yet been acknowledged by pain pump manufacturers. However, lawsuits have been filed against companies that manufacture, market or distribute the pain pumps, alleging that they failed to warn the medical community that the safety of using the pain pumps in the shoulder joint has not been established, and that the continuous injection of commonly used anesthetics by these devices may cause permanent injury.
PAGCL
Treatment for this condition is further surgery; however, many patients never regain full use of their shoulder joint. It is usually diagnosed with an x-ray showing the narrowing of the shoulder joint space. The symptoms of PAGCL are:
Increased pain in the shoulder at rest and with motion
Increased stiffness in the shoulder
Clicking, popping or grinding (Crepitus) in the shoulder
Decrease in range of motion in the shoulder
Loss of strength
Joint space narrowing as shown on an x-ray
If you've had arthroscopic shoulder surgery and are experiencing any of the above symptoms you should contact your doctor immediately. And you may have a claim against the manufacturers of shoulder pain pumps.
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