Michael Fu, MD - HSS Shoulder Surgery

Michael Fu, MD - HSS Orthopedic Surgeon and Shoulder Specialist

Arthroscopic Capsular Release for Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, or adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It occurs when the capsule of the shoulder joint becomes thick and tight, limiting motion. While the condition often improves over time with conservative treatments, some cases may require more interventional approaches like arthroscopic capsular release surgery and manipulation under anesthesia (MUA) for significant relief.

Understanding Frozen Shoulder

Frozen shoulder typically develops in three stages: the freezing stage (painful), the frozen stage (stiff), and the thawing stage (gradual improvement of motion). The exact cause remains unclear, though it is more common in individuals recovering from medical conditions or procedures that prevent the shoulder from moving freely. It has also been associated with menopause, thyroid conditions, and diabetes.

Conservative Treatments

Initial treatment for frozen shoulder often involves non-surgical methods such as:

• Pain relief medications

• Corticosteroid injections

• Physical therapy focusing on shoulder mobility exercises, with daily home stretching exercises

These treatments aim to alleviate pain and restore motion gradually. Frozen shoulder may take many months to improve, sometimes over a year. However, if significant improvement is not seen, more invasive options may be considered.

Arthroscopic Capsular Release Surgery

Arthroscopic capsular release is a minimally invasive surgical procedure that may be considered when conservative treatments fail. The surgery involves:

• Making small incisions around the shoulder.

• Inserting an arthroscope (a small camera) to guide the procedure.

• Cutting through the tight portions of the shoulder capsule to release the tension and improve mobility.

Manipulation Under Anesthesia (MUA)

Once the capsule has been released, the arm is then gently manipulated to stretch or break up the adhesions and scar tissue in the shoulder capsule.

This entire procedure is usually performed under regional anesthesia and often results in a rapid improvement in range of motion and discomfort. The minimally invasive nature of the surgery allows for a quicker recovery time compared to open surgery options.

Recovery and Rehabilitation

Post-procedure rehabilitation is crucial following arthroscopic capsular release and MUA. Patients are typically advised to begin physical therapy immediately after surgery to maintain the range of motion that was achieved during the procedure, and to prevent scar tissue from reforming. Recovery times can vary, but most patients experience significant improvements in pain and mobility within the first few weeks post-procedure. It’s essential to follow the rehabilitation plan closely and communicate with your healthcare provider about any concerns during recovery.

Conclusion

Frozen shoulder can be a debilitating condition, significantly affecting an individual's quality of life. While conservative treatments are effective for many, arthroscopic capsular release surgery and manipulation under anesthesia may be an option for those seeking relief from severe symptoms. This procedure, followed by dedicated rehabilitation, can significantly improve shoulder mobility and reduce pain, offering patients a path back to normalcy. Please contact our office for a consultation to determine the most appropriate treatment plan for individual cases.

About the Author

Disclaimer: All materials presented on this website are the opinions of Dr. Michael Fu and any guest writers, and should not be construed as medical advice. Each patient’s specific condition is different, and a comprehensive medical assessment requires a full medical history, physical exam, and review of diagnostic imaging. If you would like to seek the opinion of Dr. Michael Fu for your specific case, we recommend contacting our office to make an appointment.