Articular cartilage and local anaesthetic: A systematic review of the current literature

Abstract Background Chondrolysis involves the breakdown of cartilage following arthroscopic surgery, most commonly affecting the glenohumeral joint. Methods This review summarises all clinical and laboratory studies regarding local anaesthetic (LA) and its association with chondrolysis. We identified 289 papers, 41 of which met our inclusion criteria and were included in the final review. Results Bupivacaine, lidocaine, ropivacaine and levobupivacaine are all toxic to cartilage. Intra-articular infusions confer a greater toxicity to cartilage than single injections. Conclusions Intra-articular LA pain pumps carry a high risk of chondrolysis and should be avoided. Further studies are indicated to assess long-term single exposure LA implications.