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Infusion of bupivacaine with epinephrine associated with development of knee chondrolysis
Patients who received intra-articular infusion of bupivacaine with epinephrine postoperatively after arthroscopic ACL reconstruction were at risk for developing knee chondrolysis, according to study results.
Researchers reviewed the charts of all patients treated with arthroscopic ACL reconstruction between January 2004 and December 2006. Forty-six patients were included in the exposure group and received postoperative infusion of bupivacaine with epinephrine through an intra-articular pain pump, and 59 patients were part of a control group and did not receive postoperative infusion.
Jason Shin
Results showed 28.3% of patients who received an intra-articular pain pump developed chondrolysis, whereas no patients in the control group developed chondrolysis. The researchers also reported 32 patients in the exposure group were exposed to 0.5% bupivacaine with epinephrine and 37.5% developed chondrolysis. Another 14 patients in the exposure group were exposed to 0.25% bupivacaine with epinephrine and 7.1% developed chondrolysis.
According to the researchers, patients had a significantly higher incidence of chondrolysis when exposed to 0.5% bupivacaine with epinephrine compared with the patients exposed to 0.25%. Results also showed severe pain and limitations in daily activity among patients with chondrolysis. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.