Adhesive capsulitis (frozen shoulder) is characterized by loss of shoulder range of motion and pain caused by irritation, inflammation, and contracture (scarring and tightening) of the capsule and ligaments of the glenohumeral (shoulder) joint.
Normally, the shoulder capsule and ligaments are loose enough to allow a large range of motion. In adhesive capsulitis, inflammation causes these tissues to scar, thicken, and contract, which tightens the shoulder, restricts movement, and causes pain.
While adhesive capsulitis can usually be treated conservatively with physical therapy, injections, and medication, arthroscopic surgery to release the capsule and restore range of motion may be indicated when conservative treatment fails.
What Is Arthroscopic Capsular Release?
Arthroscopic capsular release is a procedure used to release the tight, scarred shoulder capsule and restore range of motion.
Through small arthroscopic incisions, Dr. Chudik inserts a camera into the shoulder joint to examine the structures in the joint. Special arthroscopic instruments are then used to release the contracted capsule.
After releasing the capsule, Dr. Chudik moves the shoulder to make sure range of motion has been restored.
Who Is a Candidate?
Arthroscopic capsular release may be considered for patients with adhesive capsulitis (frozen shoulder) when conservative treatment with physical therapy, injections, and medication has failed.
Surgery may not be appropriate in the presence of:
- Infection
- Poor general health that is not sufficient to proceed with surgery
- An inability or unwillingness to complete the postoperative program, including physical therapy three times per week and frequent daily home exercises for three to six months
How the Procedure Is Performed
The procedure is performed as outpatient surgery, allowing patients to go home the same day. General anesthesia with an interscalene block is used.
Through small arthroscopic incisions, Dr. Chudik places a camera into the shoulder joint to examine the structures within the joint. Special arthroscopic instruments are then used to release the tight and inflamed capsule.
After the capsule is released, Dr. Chudik moves the shoulder to confirm that range of motion has been restored.
Recovery and Rehabilitation
Following surgery:
- The sling is discontinued and motion exercises begin as soon as possible.
- Patients may feel more comfortable sleeping upright on a couch or recliner after surgery.
- The wound should remain clean and dry for three days following arthroscopic surgery.
- Light showering may begin after three days, but the wound should not be submerged under water for three weeks.
- Driving may resume after sufficient shoulder range of motion and strength have returned, usually in one to two weeks.
- Patients may return to school or sedentary work in approximately three days to one week.
- Repetitive reaching, lifting, carrying, and overhead activities should be avoided during the early recovery period.
- Physical therapy should begin two to three days after surgery and continue for three to six months.
The success of capsular release is highly dependent on postoperative rehabilitation, making it important to follow and maintain the prescribed therapy schedule.
Patients may return to unlimited activities when there is no pain and full shoulder range of motion, muscle strength and endurance, and functional use have been restored. This usually requires three to six months following capsular release. Dr. Chudik will determine when it is safe to resume all activities.
Risks and Outcomes
Potential surgical risks and complications include:
- Persistent shoulder weakness within two to three months. Diabetic patients have a higher recurrence rate and may require additional treatment.
- Infection
- Continued or recurrent pain
- Persistent stiffness or loss of shoulder motion
- Inability to return to the same level of athletics or work
Why Dr. Chudik for Arthroscopic Capsular Release
Dr. Chudik treats the full spectrum of shoulder stiffness, from primary adhesive capsulitis to post-traumatic and post-surgical patterns. His arthroscopic experience allows precise capsular release that addresses the specific contracted regions while preserving normal capsular structures, which contributes to faster recovery and lower recurrence rates.