Adhesive Capsulitis—Arthroscopic Surgery
En Español (Spanish Version)

Definition
Adhesive capsulitis is a tightening in the shoulder joint. It decreases the range of motion in the shoulder and causes pain. This condition is also known as frozen shoulder . It is caused by tightening of the soft tissue and formation of scar tissue.

During this arthroscopic surgery, the doctor cuts and removes scar tissue around the shoulder. The goal of the procedure is to improve range-of-motion by breaking up scar tissue

Frozen Shoulder

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Reasons for Procedure
This procedure is done to:
  • Relieve pain
  • Restore range of motion in the shoulder joint
  • Break up scar tissue

Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have arthroscopic shoulder surgery, your doctor will review a list of possible complications which may include:

  • Bleeding
  • Infection
  • Pain
  • Nerve injury
  • Damage to soft tissue
  • Instability or stiffness in joint
  • Fracture
  • Reaction to anesthesia used
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity
  • The use of certain medications
Prior shoulder surgery may also increase your risk of complications.

What to Expect
Prior to Procedure
Your doctor may do the following:
  • Physical exam
  • Blood and urine tests
  • X-ray —to look for any damage to the shoulder bones
  • MRI scan —to look for damage to the shoulder structures

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Aspirin or other anti-inflammatory drugs
  • Blood thinners, such as clopidogrel or warfarin

Leading up to the procedure:
  • Arrange for a ride to and from the hospital. Also, arrange for help at home after the surgery.
  • The night before, eat a light meal. Do not eat or drink anything after midnight. If you have diabetes, you may need to adjust your medicines. Talk to your doctor about this.
  • If told to do so by your doctor, on the day of the surgery, shower using a special antibacterial soap. Do not use deodorant.

Anesthesia
General anesthesia is often used for this surgery. You will be asleep.

Description of the Procedure
Three small incisions will be made in your shoulder. A special tool called an arthroscope will be inserted. An arthroscope is a flexible tube with a light at the end and a camera attached. This will allow the doctor to view the inside of the shoulder on a screen. Tiny instruments will be inserted into the other incisions. The doctor will then cut and remove scar tissue. The incisions will be closed with stitches.

Immediately After Procedure
You will be taken to a recovery room after surgery. You will be monitored for any adverse reactions to surgery or anesthesia.

How Long Will It Take
About 1-½ to 2 hours

How Much Will It Hurt?
Anesthesia will block pain during the procedure. In some cases, the doctor implants a pain pump into the shoulder. This pump slowly delivers pain medicine. It may be used for the first couple of days and then removed. Afterwards, you will have medicine to help manage the pain.

Average Hospital Stay
If there are no complications, it may be possible to leave the hospital on the same day. Talk to your doctor to see if this is an option in your case.

Post-procedure Care
During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
Your shoulder will be sore for a few weeks. It can take 3-6 months to fully recover.

When you return home, you may be asked to do the following to help ensure a smooth recovery:

  • Use a sling if told to do so by your doctor. You may not need to use one, because it can cause stiffness.
  • Work with a physical therapist at home to focus on range-of-motion exercises .
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
  • Signs of infections, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
  • Cough, trouble breathing, or chest pain
  • Severe nausea or vomiting
  • Pain becomes worse or swelling increases
  • Tingling or numbness that will not go away, especially in arms and hands
In case of an emergency, call for medical help right away.




RESOURCES:
American Academy of Orthopaedic Surgeons

American Orthopaedic Society for Sports Medicine

CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
Adhesive capsulitis. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20030315/1323ph.html. Accessed December 14, 2011.

Adhesive capsulitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 2008. Accessed December 3, 2008.

Adhesive capsulitis (frozen shoulder). Palo Alto Medical Foundation website. Available at: http://www.pamf.org/sports/king/adhesive_caps.html. Accessed December 3, 2008.

Adhesive capsulitis: physical therapy. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about. Updated June 2007. Accessed November 18, 2008.

Examination under anesthesia. University of Washington Orthopaedics and Sports Medicine website. Available at: http://www.orthop.washington.edu/uw/examination/tabID__3376/ItemID__207/PageID__425/Articles/Default.aspx. Accessed November 21, 2008.

Frozen Shoulder. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00071. Accessed December 14, 2011.

Outpatient surgery. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/florida/weston/hospital/outpatient_surgery.aspx. Accessed November 21, 2008.

Patient information guide: frozen shoulder syndrome. American Academy of Orthopaedic Surgeons website. Available at: http://orthodoc.aaos.org/mobyparsons/Pat%20Guide%20Frozen %20 Shoulder.doc. Accessed December 4, 2008.

Shoulder Arthroscopy. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00589. Accessed December 14, 2011.

Warner JP. Frozen shoulder: diagnosis and management. J Am Acad Orthop Surg. 1997;5:130-140.

Your shoulder surgery. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00066. Updated August 2009. Accessed December 14, 2011.

Last Reviewed December 2012



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