Introduction: Shoulder arthroplasty is generally a successful procedure. However, in a small percentage excessive pain or limitation of motion, does occur. We examine the role of arthroscopy in the diagnosis and treatment of these patients.

Methods and Results: Between 1995–2000, 29 patients who had excessive pain or limitation of motion following arthroplasty underwent arthroscopy. Time between procedures was 37.3 months (range 4–95).

Impingement syndrome confirmed and successfully treated by ASD in 10, a rotator cuff tear in 3. Loose bodies removed in 1. Arthroscopic washout was performed in 1 patient for acute septic joint. 6 of 7 with capsular fibrosis underwent a successful arthroscopic capsular release. Loose or worn components were found in 4, a florid synovitis in 1, loose cement in another and in 1 no abnormality could be found.

Discussion: Arthroscopy is a useful tool for diagnosis and treatment of painful or stiff shoulder arthroplasty. However, it leads to a number of technical difficulties. Orientation within the joint is often hindered as the reflection from the prosthesis makes it difficult to differentiate between the real and mirror images of the tissues and arthroscopic instruments. Access is often compromised in stiff shoulders.

Conclusion: Arthroscopy following shoulder arthroplasty is useful for the diagnosis and treatment of pain and loss of motion in selected patients, but can be technically difficult. Diagnostic arthroscopy following shoulder arthroplasty should be considered for patients suffering from pain in whom no cause could be found using less invasive investigations.