In the following case a revision of a stiff painful hemiarthroplasty to an anatomic total shoulder replacement is demonstrated. There was a "moonlight" period of several years of improvement in pain after the index hemiarthroplasty which was followed by progressive stiffness and pain. For that reason, a biopsy using the arthroscope was performed prior to the conversion to the anatomic total shoulder prosthesis which did not indicate any signs of infection after holding the cultures for 21 days. The biopsy is helpful in those situations, it is a fast and relatively benign procedure and it does answer the question of p. acnes infection. The patient had a pain free shoulder after the revision surgery. Post op and preop images as well as arthroscopic imaging and preop MRI arthrogram done at an outside institution are demonstrated.
Arthroscopic picture shows the loss of the cartilage on the glenoid side.
