Arthroscopic Capsular Release
What is a Frozen Shoulder (adhesive capsulitis)?
A frozen shoulder is due to tightening and thickening of the ligaments and other supporting structures (capsule) of the shoulder. This tightening and thickening results in a severe restriction in range of motion.
How do you release the capsule?
The capsule will be released by making small incisions around the shoulder and by use of an arthroscope (camera) to see all the structures of the joint. Special instruments allow Dr. Gillespie to cut the capsule and restore range of motion.
Length of Stay
Occasionally you will stay overnight to start range of motion exercises. In most cases this is done as an outpatient surgery. If you are scheduled to go home same day, you will need someone to drive you home.
Patients usually have two types of anesthesia for this surgery. The first is general anesthesia, which means you are asleep. The second type of anesthesia is a nerve block. Your arm will be numb. If you stay over night, a small catheter (tube) is inserted near your neck, so the anesthesia department can administer more numbing medication. The anesthesiologist will speak to you on the day of surgery. The ultimate choice of anesthesia technique is up to you and your anesthesiologist.
You will have three small incisions, one in the front and two in the back of your shoulder. There may be a fourth incision on the outside aspect of the upper arm. They will only be about 1 cm long.
You will have pain medication prescribed for you prior to discharge. After the nerve block wears off you will have discomfort. Most of the pain is related to your very swollen shoulder. That swelling will resolve in 24-48 hours.
Your arm will be placed in a sling prior to leaving the operating room. The sling is only for your comfort and protection, you do not need to wear the sling all the time.
You will go home with clear dressings and gauze. After 2 days you may remove the dressings. There will be small black sutures (stitches) that will be taken out at your first post operative appointment 5-7 days after your surgery.
For the three months of recovery you will do very aggressive stretching at home. A physical therapist will teach you the four exercises prior to discharge from the hospital. A set of stretches must be completed every hour while awake. If a CPM (constant passive motion) machine is ordered, you must use it as much as possible while awake. The CPM machine DOES NOT take the place of stretching. Every hour you must come out of the machine and complete a set of stretches.
Recovery from capsular release surgery is three months. During that time you will have restrictions on the use of your operative arm. Depending on your job most patients are able to return to work with restrictions after 6 weeks. Most importantly, you need to be able to stretch at work.
Dr. Gillespie will take photos during your surgery. Please bring those pictures to your first postoperative visit. Dr. Gillespie will review them with you and discuss exactly what was done in your shoulder.