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病例报告：关节内疼痛泵治疗后发生两例肱骨头溶解症。

Case reports: two cases of glenohumeral chondrolysis after intraarticular pain pumps.

机构信息

Department of Orthopaedic Surgery, The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.

出版信息

Clin Orthop Relat Res. 2010 Sep;468(9):2545-9. doi: 10.1007/s11999-010-1244-5. Epub 2010 Jan 29.

DOI:10.1007/s11999-010-1244-5
PMID:20112077
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2919888/
Abstract

BACKGROUND

Acute idiopathic chondrolysis in young adults is rare. The etiology often is unknown and outcomes can be devastating owing to rapid development of painful secondary osteoarthritis. There have been some recent reports of chondrolysis after arthroscopic shoulder procedures. Animal and laboratory data suggest chondrolysis is related to the use of intraarticular pain pumps, although there is no conclusive evidence that this is causative in patients.

CASE DESCRIPTION

We present two cases of young adults with chondrolysis of the humeral head after intraarticular pain pump use with humeral head resurfacing and biologic glenoid resurfacing.

LITERATURE REVIEW

Several authors report glenohumeral chondrolysis after shoulder arthroscopy involving the use of bupivacaine pain pumps. In addition, experimental animal studies have confirmed the presence of chondrolysis after bupivacaine infusion.

PURPOSES AND CLINICAL RELEVANCE

These cases provide additional evidence of an important association between postarthroscopic chondrolysis of the glenohumeral joint and the use of bupivacaine pain pumps.

摘要

背景

青年特发性急性软骨溶解症较为罕见。病因通常不明，由于继发的疼痛性骨关节炎迅速发展，其预后可能非常差。最近有一些关于关节镜肩关节手术后软骨溶解的报道。动物和实验室数据表明，软骨溶解与关节内疼痛泵的使用有关，尽管没有确凿的证据表明这是导致患者软骨溶解的原因。

病例描述

我们报告了两例使用关节内疼痛泵后出现肱骨头软骨溶解的年轻患者，他们均接受了肱骨头表面置换和生物型肩胛盂表面置换。

文献回顾

几位作者报告了在涉及布比卡因疼痛泵使用的肩关节镜手术后发生的肩盂肱关节软骨溶解。此外，实验动物研究已经证实了布比卡因输注后软骨溶解的存在。

目的和临床相关性

这些病例为关节镜检查后盂肱关节软骨溶解与布比卡因疼痛泵使用之间的重要关联提供了额外的证据。

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