Arthroscopic Complete Capsular Release for the Treatment of Frozen Shoulder

Frozen shoulder is characterized by spontaneous onset of shoulder pain accompanied by progressive stiffness and disability. It is usually self-limiting but often has a prolonged course over two to three years. Arthroscopic surgery has been used since 1990 to treat patients with frozen shoulder who failed to respond to conservative methods. A total of 27 consecutive patients with primary frozen shoulder who had failed to improve with conservative treatment for at least 3 months underwent 360 degree arthroscopic capsular release. A posteroinferior portal was established using a step cannulation system to avoid axillary nerve injury. The mean JOA pain score improved from 8.5±5.2 points to 23.1±4.1 points. The mean JOA ADL score improved from 4.1±1.7 points to 9.4±0.8 points. All range-of-motion values improved statistically from the immediate preoperative to the final postoperative state. Arthroscopic 360 degree arthroscopic capsular release provides the surgeon with the ability to divide the shoulder capsule under direct vision with greater control, and it is also an excellent treatment option for patients with frozen shoulder which has proven resistant to conservative management.