Shoulder surgery can be a particularly painful ordeal, and pain management is an important part of the treatment process. Intra-articular pain pumps are one of a number of techniques used for managing pain. Use of the pump is thought to prolong the effects of other numbing agents for several days. Unfortunately, this relief often comes at a cost. Evidence is growing that use of these devices has been associated with a painful condition called Postarthroscopic Glenohumeral Chondrolysis (PAGCL).
Intra-articular pain pumps are implanted into the shoulder joint during surgery and release pain medications directly to the joint. In most cases, the pumps do what they are meant to, and offer patients effective pain control. However, some patients experience PAGCL, a progressive loss of cartilage in the shoulder joint following this surgery. For a long time, physicians were unable to determine what caused this damage. Last year, one of the first studies to look at this problem was published. The study looked at the medical charts of 152 patients who had undergone anthroscopic shoulder surgeries. Twelve of the patients developed PAGCL, and all of them had received pain pumps during their surgeries. The use of the intra-articular pain pump was the only factor that the PAGCL patients had in common. While this analysis is not conclusive, it does point to a need for more investigation of this problem.
PAGCL is extremely painful and can cause life-long disability. Cartilage is a flexible tissue that cushions the bones of a joint. If cartilage is lacking, the bones will grind together. The result is extreme pain, and sometimes chronic arthritis. Symptoms of PAGCL include pain at the shoulder when it is in motion or at rest; increased shoulder stiffness; popping or grinding when the shoulder is in motion; decrease in range of motion; and a loss of strength in the joint. PAGCL is usually diagnosed with an x-ray showing the narrowing of the shoulder joint space.
A patient diagnosed with PAGCL usually has to undergo more surgery. However, surgery does not always provide complete relief, and patients can end up with more shoulder pain than they had prior to their initial surgery. Anyone contemplating shoulder surgery should discuss pain pumps with their doctors, and they must notify their physicians if they experience any of the symptoms associated with PAGCL.
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April 27th, 2009 at 1:13 pm
I’m pretty sure I have PAGCL. I had shoulder surgery in 2007 with a pain pump. I have all the symptoms of cartilidge loss and the pain is increasing. My orthopedist tells me there is nothing that can be done for this type of pain.
June 2nd, 2009 at 4:02 pm
I had a shoulder surgery in 2003 and I start to feel pain two months after and I sure that I have PAGCL but I talk to the doctor after the surgery and for months he told me that the pain was going to get worst with time and years after I developed pain in all my right arm head and leg specially in the joints and the bones its like arthritis Its painfull
January 26th, 2010 at 6:20 am
2006 I had a first rib removed on both sides which is in the shoulder area, this was due to thoracic outlet syndrom
I have all the the symptoms of PAGCL
and my dr will not see me over a 80 dollar bill left owing after surgury back in 06 , I was told I would end up with nerve damage the rest of my life, I now have a big tear in the glemohumeral legiment and arthritis very painful to do anything, cant get a dr to diagnose with PAGCL but have all the symptoms after a pain pump was used were do I turn to??