An arthroscopic technique for treating patients with frozen shoulder

Forty-three patients with a diagnosis of primary or secondary frozen should er who had symptoms for an average of 12 months and failed conservative tre atment of at least 12 weeks of physical therapy, were treated with an arthr osopic capsular release. Oon completion of standard shoulder arthroscopy, i ntra-articular cautery wets used to completely divide the anterior-inferior capsule, the intraarticular portion of the subscapularis tendon, and the m iddle glenohumeral, the superior glenohumeral, and the coracohumeral ligame nts. The subacromial space was inspected in all patients. Eighteen patients had extensive subacromial fibrosis that required debridement. Subacromial decompression was reserved for patients with evidence of an acromial spur s een at the time of arthroscopy. Postoperatively, all patients showed substa ntial gains in shoulder range of motion, as well as diminished shoulder pai n. Thirty-five patients completed a telephone survey at an average of 22 mo nths after surgery. The average modified shoulder score was 19 (scale 13 to 65), with 83% of patients indicating that their shoulder was normal or cau sed only mild symptoms. In conclusion, the authors believe that arthroscopi c capsular release is an effective and safe alternative to manipulation in patients with a recalcitrant frozen shoulder.