Arthroscopic capsular release for adhesive capsulitis of the shoulder joint
This procedure is recommended in those who fail to respond to conservative treatment measures such as steroid injection into the shoulder joint and physiotherapy. In this procedure the tight capsule (lining of the shoulder joint) and tight muscles are released and shoulder movements are gained.
Steps of the Surgery
Arthroscopic capsular release for the frozen shoulder joint is done by two or three tiny incisions of less than 1cm. The stab incisions are done around the shoulder joint. Tiny tubular camera is introduced through this stab incision and the shoulder joint is thoroughly visualized. The lining of the shoulder joint called capsule is usually thick and contracted in this condition. The tight capsule around the socket of the shoulder joint is released with the help of special radio frequency probe. A muscle called subscapularis, which is also tight in this condition, is also released with the help of this radiofrequency probe. This radiofrequency probe generates heat and cuts the tissue in a controlled fashion.
Once the capsule is cut around the socket of the shoulder joint, gentle manipulation of the shoulder joint is performed. This ensues that the full range of motion of the shoulder joint is achieved. Once the surgery is performed, the tiny stab incisions are closed with a small stitch to the skin.
The physiotherapist will see in the postoperative ward and will teach the exercises that needs to be performed over the next few weeks in order to preserve the joint motion that were acquired by arthroscopic surgery.
The Success Rates and the Outcomes
The success rate of this surgery is variable, but it is better than other forms of treatment. Complications are minimal. There may be small oozing from the wounds sometimes, but usually the swelling and the oozing settles down in a week or two.
Infection, chondral damage and axillary nerve damage have been reported as rare complications