There was a story reported in this week’s New York Times and elsewhere about a rare disorder called chondrolysis that has been seen to occur after certain surgeries. Chondrolysis is the unexpected deterioration of cartilage in the joint. These particular procedures have employed a “pain pump” – a recently developed device used to slowly inject local anesthetic into the joint after surgery. In theory this technology should decrease post-op pain and increase the patient’s comfort. Unfortunately, it turns out that the anesthetic drugs we routinely use all over the body can actually be toxic to the joint if injected consistently over a period of days. These new devices were never tested for this specific application but were approved for similar uses throughout the body; no one expected these results when the pumps were used directly in joints.

My daughter desperately wants an IPad. It seems soooo cool she has told me on multiple occasions since its announcement 48-hours ago. I told her “it is never a good idea to be the first one to get something new, remember all the problems with the first generation IPhones and Blackberry Storms.” I told her to let someone else be the guinea pig, and once the kinks were worked out we would reassess and consider buying one. The downside of this philosophy is not being the coolest kid in school right away; you can’t tell your friends about your new device and attract the eye of that cute boy or girl before anybody else.

In medicine there are real pressures to be that cool kid. To compete you often have to distinguish yourself from your colleagues. Being the first to offer some new technology that decreases post operative pain can make you more popular, like the kid with the first IPad. I have succumbed to this type of temptation in the past with other new technologies – those devices were approved for my applications. I have not implanted any pain pumps into joints and none of my patients have chondrolysis.

For now my daughter will not be the first in her school to get an IPad. I will also not be the first surgeon to try some new technology. I will watch carefully and when technology is proven safe and offers a real advantage for my patients I will be all over it. I am sure when IPad 2.0 is released I will be all over that too.

Jeffrey Passick, M.D.

Dr. Passick is the Director of Orthopedics at Coney Island Hospital. He can be contacted at 718-616-3440.

This entry was posted on Friday, January 29th, 2010 at 4:24 pm and is filed under Orthopedics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.