Assessment of a painful shoulder arthroplasty

The assessment of a painful shoulder replacement benefits from a systematic approach to determine the underlying cause(s) and appropriate management strategies. This review provides an overview of the assessment, investigation and management of the painful shoulder replacement using a superficial to deep methodical analysis based on the anatomy of the shoulder. The intersection of pathoanatomy, pathobiomechanics and symptoms is explored in terms of the common causes of pain. Common causes of pain including conditions characterised by contractures, weakness, instability, aseptic loosening, periprosthetic joint infection, periprosthetic fracture, neurological injury, and metal hypersensitivity are discussed. Prosthesis-specific complications for hemiarthroplasty, anatomical and reverse total shoulder arthroplasty are briefly discussed.