Pain Pumps and PAGCL
A recent study published by The American Journal of Sports Medicine (Postarthroscopic Glenohumeral Chondrolysis , July 2007) identified intra-articular pain pumps as the likely cause of a condition known as Postarthroscopic Glenohumeral Chondrolysis (PAGCL). This is a devastating condition that can cause severe pain and stiffness in the affected shoulder, along with limitations on range of motion, reduced strength and the need for constant pain management. It is not uncommon for patients afflicted with PAGCL to require repeat surgical procedures, and the condition may ultimately require shoulder joint replacement surgery.
Furthermore, a paper presented at a 2006 meeting of the American Academy of Orthopedic surgeons showed that of 152 patients who underwent arthroscopic surgery, 12 developed PAGCL. All 12 patients who developed PAGCL after the surgery also had a pain pump during their surgeries. In fact, use of the pain pump was the only factor that all patients had in common.
WHAT IS PAGCL?
Postarthroscopic Glenohumeral Chondrolysis actually means a breakdown of the cartilage in the glenohumeral joint (the shoulder joint) following arthroscopic surgery. Essentially, the cartilage in the patient’s shoulder deteriorates, causing pain and stiffness. In some cases, the patient completely loses the ability to use the shoulder.
Symptoms of PAGCL include:
- Pain when the shoulder is in motion and/or at rest
- Clicking, popping and/or grinding,
- Weakness or stiffness in the shoulder, and
- Decreased range of motion.
WHAT IS THE PROGNOSIS FOR INDIVIDUALS DIAGNOSED WITH PAGCL?
Most patients who develop PAGCL will require surgery. Although some patients feel better with the use of anti-inflammatory medications, those who have lost all their cartilage require shoulder replacement surgery. Replacement surgery (arthroplasty) involves replacing the shoulder joint with plastic and metal parts. The surgery generally takes two to three hours to perform and patients may be required to stay in the hospital for up to three nights. Patients usually require physical therapy following the surgery.