Arthroscopic capsular release
Arthroscopic capsular release is a minimally invasive surgery to treat a frozen shoulder.
What is arthroscopic capsular release?
Arthroscopic capsular release is keyhole surgery for the treatment of a frozen shoulder, also known as adhesive capsulitis. It aims to release the tight capsule surrounding your shoulder joint to regain a full range of free movement and reduce your pain.
This surgery tends to be used to treat a frozen shoulder that has not responded to other forms of treatment, including corticosteroid injections and shoulder manipulation and physiotherapy.
You are given a local or general anaesthetic beforehand. Your surgeon makes a few small incisions on your shoulder and inserts an arthroscope and a radiofrequency (RF) probe. The arthroscope has a camera that allows your surgeon to see inside your shoulder. The probe uses RF waves to cut the capsular tissues surrounding your shoulder joint and allow your shoulder to move more freely.
What causes a tight shoulder capsule?
Your shoulder capsule is the lining of your shoulder joint. It is normally quite loose so that you can easily stretch your arm in all directions.
A tight shoulder capsule is caused by its lack of use. The capsule becomes thick, stiff, and inflamed and this makes your shoulder even more difficult to move. Your shoulder becomes frozen in its position. A frozen shoulder is painful and means you have limited shoulder movement.
With a frozen shoulder, you can expect to find it difficult lifting up your arm, turning it outwards and putting it behind your back.
How painful is the surgery?
You will not feel any pain during the procedure as it is performed under local or general anaesthetic. If you had a local anaesthetic or nerve block, your arm will feel numb. Your anaesthetic will usually wear off during the first 24 hours after the operation. You should start taking pain relief before the anaesthetic wears off and continue to take it regularly initially to keep the pain under control.
You will probably have some bruising and swelling to your arm after your surgery. Post-operative pain is normal. We will advise you on your pain medication for your return home to help minimise this pain.
The pain should gradually settle down after around six weeks. You must keep your shoulder moving and stretched to prevent it from stiffening up again. You should follow your physiotherapists exercise advice. You may experience aching, discomfort or stretching during and after these exercises.
How long does it take to recover from arthroscopic capsular release?
Recovery from arthroscopic capsular release to a full range of movement can take three months or longer.
Physiotherapy is important to aid your recovery. It encourages movement, helps with pain management and rehabilitates your muscles back to their normal function.
Most people are able to return to light work (no heavy lifting) after two to four weeks following a capsular release. If your work involves heavy or overhead work, you may delay your return to four to six weeks after your surgery.
It is not advisable to drive until you have enough movement and stretch in your arm to be able to control the car safely.
You should avoid sustained overhead activities for three months. If you are a swimmer, you may resume breaststroke as soon as you are comfortable but wait three months before restarting the front crawl. You can play golf six weeks after your shoulder surgery. You should speak to your physiotherapist for specific advice and guidance on other sports and lifestyle activities.