Arthroscopy for failed shoulder arthroplasty.
OBJECTIVE
It was the purpose of this study to describe the specifics of technique and results of arthroscopic evaluation and treatment of failed shoulder arthroplasties in 10 patients with early and late complications of shoulder arthroplasty.


METHODS
Case series.


METHODS
Ten patients (2 bilateral) underwent 13 arthroscopies after poor results following shoulder arthroplasty. The arthroscopic diagnoses ranged from rotator cuff tears in 5 shoulders, fibrosis and scarring of the long head of the biceps in 5 shoulders, impingement and biceps tendinitis in 1 shoulder, and capsular contracture in 1 shoulder. We performed 4 mini-open rotator cuff repairs, 1 open rotator cuff repair with revision of the humeral component, 5 arthroscopic debridements of the long head of the biceps, 2 arthroscopic decompressions with biceps tenodesis, and 1 arthroscopic capsular release.


RESULTS
Before arthroscopy, the preoperative Hospital for Special Surgery (HSS) scores were 6 fair and 6 poor. At latest follow-up, there were 3 excellent, 4 good, and 5 fair results. There was a statistically significant improvement in HSS scores and range of motion for all patients in this study. All patients were satisfied with the results of the procedure. There were no infections or wound problems and neurovascular status was unaltered after arthroscopy. There was 1 intraoperative complication, a periprosthetic humerus fracture after manipulation in an osteoporotic woman with rheumatoid arthritis.


CONCLUSIONS
Arthroscopy proved to be a reliable diagnostic and therapeutic tool in dealing with some of the postoperative complications encountered both early and late after shoulder arthroplasty. Careful attention to surgical technique, including use of blunt trocars, traction, and intraoperative prophylactic antibiotics, can minimize complications of arthroscopy in this setting.
Hersch
J C
JC
Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Dines
D M
DM
D000328:Adult; D019643:Arthroplasty, Replacement; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012785:Shoulder Joint / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome