Schröter S, Lutz O, Gonser C E, Ateschrang A, Badke A, Albrecht D
Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard Karls Universität Tübingen, BG Unfallklinik Tübingen.
Z Orthop Unfall. 2011 Dec;149(6):688-93. doi: 10.1055/s-0030-1270919. Epub 2011 Apr 8.
Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication of shoulder arthroscopy. PAGCL describes a chondrolysis in the shoulder joint after arthroscopy mostly affecting younger patients. The process leading to chondrolysis is not known yet.
The case report describes a patient with rapid progress of the PAGCL. A literature review with key words: PAGCL, postarthroscopic glenohumeral chondrolysis, shoulder arthroscopy AND chondrolysis, chondronecrosis AND arthroscopy was carried out.
16 Publications involving case reports with 96 cases were found. The mean age at operation was 28 ± 10 years (range: 13 to 61 years). The majority of patients (62%) were male. 8 diagnoses at index operation were found. 63% received intraarticular local anaesthetics (62% bupivacain, 21% bupivacain and epinephrin, 2% lidocain) through a pain pump.
PAGCL is a rare and disturbing complication after shoulder arthroscopy. The majority of the patients are young and male. A relevant causal factor is an intraarticular pain pump with bupivacain. Other factors have not yet been verified. A multifactorial aetiology is likely. No specific and effective treatment regimen is described.
关节镜术后肱盂关节软骨溶解(PAGCL)是肩关节镜检查的一种罕见并发症。PAGCL指关节镜检查后肩关节出现的软骨溶解,主要影响年轻患者。导致软骨溶解的过程尚不清楚。
该病例报告描述了一名PAGCL进展迅速的患者。进行了文献综述,关键词为:PAGCL、关节镜术后肱盂关节软骨溶解、肩关节镜检查、软骨溶解、软骨坏死、关节镜检查。
发现16篇涉及病例报告的文献,共96例。手术时的平均年龄为28±10岁(范围:13至61岁)。大多数患者(62%)为男性。索引手术时有8种诊断。63%的患者通过镇痛泵接受关节内局部麻醉(62%为布比卡因,21%为布比卡因和肾上腺素,2%为利多卡因)。
PAGCL是肩关节镜检查后一种罕见且令人困扰的并发症。大多数患者为年轻男性。一个相关的因果因素是使用含布比卡因的关节内镇痛泵。其他因素尚未得到证实。病因可能是多因素的。未描述具体有效的治疗方案。