Do intra-articular local anesthetiics cause chondrolysis? [İntra-arti̇küler lokal anestezi̇kler kondroli̇zi̇ se neden olur mu?]

Today,the administration of local anesthetic drugs into the joint space either by single injection or by continuous infusion,has been admitted as a well-defined technique for perioperative analgesia,particularly in shoulder or knee arthroscopic surgery and also for analgesia in rheumatismal diseaes. however,recent clinical case reports that mentioned potential toxicity to articular chondrocytes with prolonged exposure to local anesthetics used either alone or in combination with other drugs have caused arising concerns about this technique. in this context,animal studies have shown that local anesthetics,particularly bupivacaine are toxic to chondrocytes depending on the dose and the time. the aim of this review is to make a point of health care professionals,especially anesthesiologists and orthopedic surgeons,to avoid using local anesthetics at high concentrations,for prolong periods and particularly with epinephrine into the articular space.