Peri-capsular Release

Peri-Capsular Release

Adhesive Capsulitis/Frozen Shoulder

Frozen shoulder, medically known as adhesive capsulitis, induces discomfort and rigidity within the shoulder joint. With its progression, mobility of the shoulder severely diminishes. This condition predominantly afflicts individuals aged between 40 and 60, with a higher incidence among women compared to men. Moreover, those with diabetes face an elevated likelihood of developing frozen shoulder. The condition involves the thickening of the shoulder capsule, leading to stiffness and tightness, accompanied by the formation of dense bands of tissue known as adhesions. Often, there is a reduction in the presence of synovial fluid within the joint.

The exact causes of frozen shoulder remain elusive. There doesn’t seem to be a clear correlation with arm dominance or occupation. However, certain factors may increase the likelihood of developing this condition.

Diabetes: Individuals with diabetes are more prone to frozen shoulder, although the precise reasons are unclear. Moreover, diabetic patients with frozen shoulder often experience prolonged stiffness before gradual improvement.
Other medical conditions: Frozen shoulder can be associated with various other health issues such as hypothyroidism, hyperthyroidism, Parkinson’s disease, and cardiac disease.
Immobilization: After prolonged immobilization due to surgery, fractures, or other injuries, frozen shoulder can develop. Encouraging shoulder movement soon after injury or surgery is recommended to prevent the onset of frozen shoulder.

Most patients with frozen shoulder get relief from a non-surgical treatment like NSAIDs and physical therapy with steroid injection. If the frozen shoulder does not respond to conservative treatment surgical option with the pericapsular release is the treatment of choice.

Manipulation under anaesthesia (MUA) without arthroscopic capsular release is effective but may result in iatrogenic injury, including fracture. Arthroscopic capsular release involves the selective release of the capsule, often with electrocautery, to minimize the risk of iatrogenic injury compared with MUA. Secondarily, this may decrease postoperative pain and facilitate early participation in physical therapy. In this procedure, arthroscopically, the surgeon cuts through the scar tissue that has formed in your shoulder joint capsule to allow free movement of your shoulder. Many patients find that surgical capsular release can offer permanent relief from the frozen shoulder in conjunction with a physical therapy program.