Frozen Shoulder Surgery Overview

Arthroscopic Capsular Release for Frozen Shoulder

frozen shoulder surgery

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Frozen shoulder is a painful condition, also called adhesive capsulitis. Patients who have a frozen shoulder have difficulty with even simple movements of the joint. Typical symptoms of a frozen shoulder include pain when moving the arm, even with simple activities such as washing hair, buckling a seatbelt, or fastening a bra. The condition is caused by scarring of the shoulder capsule, the thick lining of the shoulder joint.

Treatment of a frozen shoulder is almost always successful with simple, non-surgical treatments. While the treatments may be simple, recovery from the condition can take months, or even years and some patients fail to completely improve. Patients who have tried these methods to improve their shoulder mobility, and are still restricted by pain and stiffness, surgery may be considered for a frozen shoulder.

Frozen Shoulder Surgery

The usual surgical treatment of a frozen shoulder is called an arthroscopic capsular release. As is evident from the name, this is an arthroscopic shoulder surgery where a small camera is inserted into the shoulder joint. Through other small incisions, small instruments can also be inserted to treat the problem.

In the case of a frozen shoulder, the problem is the tight shoulder capsule, and therefore the treatment to address this is to cut the tight capsule to allow the joint more freedom of mobility. Instruments are inserted to cut away the capsule surrounding the shoulder socket.

The most important aspect of an arthroscopic release is ensuring any improvements in shoulder mobility are maintained after surgery. Sometimes patients will have their arm specially splinted to keep the capsule of the shoulder stretched. More commonly, ​physical therapy will begin immediately following the surgery to ensure that scar tissue does not begin to re-form around the joint.​​

Alternatives to Arthroscopic Release

  • Nonsurgical Treatment: Most patients have tried nonsurgical treatment for their frozen shoulder before considering any invasive treatments. However, many patients don't realize the length of time that frozen shoulder can persist, and the fact that nonsurgical treatment may take 12-18 months before symptoms resolve. Therefore, most surgeons don't consider nonsurgical treatments to have failed unless they've been tried for many months.
  • Manipulation Under Anesthesia: Performed less commonly since arthroscopic treatment options became common, a manipulation under anesthesia (MUA) is essentially the passive stretching of your shoulder while you're asleep. The advantage is getting a much better stretch of the joint capsule, but there are possible complications. Pain can occur after this procedure, and if pushed too forcefully, it is possible for bones to break under excessive force. Often an MUA is performed after an arthroscopic capsular release.
  • Open Capsular Release: An open capsular release is a much less commonly performed surgical procedure, now that arthroscopic treatment is common. Much like the arthroscopic procedure, the shoulder capsule is divided, but by your surgeon looking directly inside the shoulder. Arthroscopic surgery is generally felt to be superior because it causes less pain, is less invasive and allows more complete access to the shoulder joint.

    Recovery From Arthroscopic Capsular Release

    While arthroscopic capsular release is very helpful to gain shoulder mobility, the trick is maintaining the improvement in motion. Because of pain associated with surgery, it is tempting to limit shoulder movements after surgical release, but doing so will likely lead to a recurrence of the original problem. As mentioned, some surgeons specially splint the shoulder, and all will begin immediate movement and therapy after surgery in an effort to maintain improvements in shoulder motion.

    A Word From Verywell

    Surgery is infrequently used for the treatment of a frozen shoulder, but there are times where nonsurgical treatments are not effective for the management of this condition. If prolonged nonsurgical treatment is not leading to relief of symptoms, surgery can be considered as an option. The most critical aspect of any type of surgery used for treatment of frozen shoulder is to ensure you get the shoulder moving as soon as possible after surgery to protect any gains in mobility and prevent new scar tissue from forming in the shoulder joint.

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