Prospective case series of arthroscopic anterior capsular release for idiopathic adhesive capsulitis that had failed both physical therapy and closed manipulation. It describes the technique and reports motion and functional outcomes at a mean of 39 months. The study asks whether a targeted arthroscopic release can restore motion in this refractory subset with low morbidity.
Work through the frozen shoulder algorithm in the order this paper does. Start with supervised physical therapy: roughly 6 in 10 idiopathic patients resolve. If motion stalls after several months, proceed to closed manipulation under anesthesia, which salvages a further subset.
Only when both fail should you consider surgical release. When you get there, the target is the rotator interval, the coracohumeral and superior glenohumeral ligaments, because that is where the dense contracture lives. Releasing it alone restored external rotation in 18 of 23 patients here.
Know the surgical safety rule for boards: do not extend the release inferior to the superior border of the subscapularis without care, because the axillary nerve is at risk. Manipulation risks humeral fracture, neural injury, and dislocation.
Also separate the diagnoses. Post-surgical or post-fracture stiffness often has an extra-articular component and will not respond as predictably to a purely capsular release.
Prospective case series of arthroscopic anterior capsular release for idiopathic adhesive capsulitis that had failed both physical therapy and closed manipulation. It describes the technique and reports motion and functional outcomes at a mean of 39 months. The study asks whether a targeted arthroscopic release can restore motion in this refractory subset with low morbidity.
Work through the frozen shoulder algorithm in the order this paper does. Start with supervised physical therapy: roughly 6 in 10 idiopathic patients resolve. If motion stalls after several months, proceed to closed manipulation under anesthesia, which salvages a further subset.
Only when both fail should you consider surgical release. When you get there, the target is the rotator interval, the coracohumeral and superior glenohumeral ligaments, because that is where the dense contracture lives. Releasing it alone restored external rotation in 18 of 23 patients here.
Know the surgical safety rule for boards: do not extend the release inferior to the superior border of the subscapularis without care, because the axillary nerve is at risk. Manipulation risks humeral fracture, neural injury, and dislocation.
Also separate the diagnoses. Post-surgical or post-fracture stiffness often has an extra-articular component and will not respond as predictably to a purely capsular release.