The role of arthroscopy for the problem shoulder arthroplasty

Between 1995 and 2000, 29 patients who had excessive pain or limitation of motion after a shoulder arthroplasty underwent arthroscopy. Preoperative diagnoses of impingement syndrome in 10 patients (treated by arthroscopic subacromial decompression), large rotator cuff tear in 1, loose bodies in 1, unstable cuff arthropathy in 1, and septic arthritis in another were confirmed at arthroscopy. Of the 15 patients without a preoperative diagnosis, 7 had postarthroplasty capsular fibrosis, with 6 undergoing arthroscopic capsular release. A malpositioned glenoid component was found in 1 patient. Loose or worn components were found in 4 of the shoulders, impingement with a small partial-thickness cuff tear was identified in 1, a florid synovitis was present in another, and in 1 no abnormality could be found. The procedures were often hindered by limited access and reflection from the prosthesis. Arthroscopy after shoulder arthroplasty is useful for the diagnosis and treatment of pain and loss of motion in selected patients but can be technically challenging.