Chondrolysis, a condition in which joint cartilage dies, leaving bone grinding against bone, is a relatively rare ailment, and certainly shouldn't be seen in young people. Yet several cases began popping up in medical journals in recent years, with reports of active young people suddenly developing the condition. Chondrolysis has ended the careers of athletes and has sometimes necessitated joint replacement. Orthopedists were initially baffled by the outbreak of chondrolysis, but recent studies seem to link the development of the condition with the use of pain pumps.
Pain pumps are often used postsurgery to deliver local anesthetics to a specific location through an inserted plastic tube. The pumps are considered safer that prescription narcotic painkillers, and allow patients to leave the hospital sooner after a surgery. Pain pumps rose in popularity in the late 1990s, even though the US FDA never cleared the pumps for use in joints. Detractors of the pumps warned of the dangers of exposing cartilage to local anesthetics for up to 72 hours, and in November 2009, the FDA issued a formal warning about using pain pumps in joints and ordered a manufacturing abel change to discourage their use in such practices.
The "outbreak" of chondrolysis cases began around 2004, when several patients, after an initial normal healing period from shoulder surgery, began noticing problems with their shoulders. In each case, orthopedists discovered that the joint cartilage had deteriorated, leaving their bones rubbing against each other. This can result in great pain, disability, and sometimes the need for a joint replacement.
A number of studies in 2006 linked pain pumps to chondrolysis, and the largest manufacturer of the pumps changed package directions to warn against use of the pain pumps in joints. That manufacturer is now the defendant in over a hundred chondrolysis cases, with more cases being brought against other manufacturers. Prosecutors say that the pump manufacturers withheld information about the danger of the pumps, while the manufacturers maintain that they never marketed the pumps for use in joints, and it was the choice of doctors to use the product "off label."
While over a hundred lawsuits are still working their way through various courts, an Oregon jury awarded almost $5.5 million to a chondrolysis patient last week.
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