Frozen shoulder syndrome is a fairly common cause of chronic shoulder pain and stiffness in adults. Symptoms occur due to swelling, inflammation, and tightness in the cartilage that covers the top of the shoulder joint. Some cases can be relieved with medications and physical therapy, but frozen shoulder surgery is needed if symptoms are severe or persist despite medical treatment. An arthroscopic procedure can be performed to loosen the joint and cut away damaged, tight cartilage tissue. Surgery is minimally invasive, low risk, and most people experience near full recoveries with a few follow-up physical therapy sessions.
Before considering frozen shoulder surgery, doctors try to combat the condition with oral anti-inflammatory drugs, corticosteroid injections, and massage. If cartilage tissue is simply inflamed and not seriously damaged, non-surgical techniques are usually enough to relieve symptoms. A case of frozen shoulder that goes undiagnosed or untreated, however, can lead to permanent joint tissue scarring that does not respond to drugs or exercise. Frozen shoulder surgery may be the only option to restore range of motion and ease chronic pain.
Frozen shoulder surgery is usually performed in an outpatient orthopedic surgical center. Most procedures can be completed in less than two hours, and patients are typically allowed to go home on the same day of their operations. Before the surgery, the patient is instructed to lie down on his or her back. The shoulder is sterilized and an anesthesiologist provides a general sedative. The orthopedic surgeon then marks two to four points around the top of the shoulder to guide incisions.
A very small cut is made at one of the marks and a fiber optic camera tube called an arthroscope is inserted into the joint. The arthroscope relays real-time images to a computer monitor so the surgeon can guide the operation without needing to cut open the entire shoulder. Once the camera is in place, the surgeon can inspect tendons, ligaments, and bones to make sure they are not damaged in addition to the scarred cartilage.
Scalpels, clamps, and other precision surgical instruments can then be inserted through another small incision in the shoulder. With the help of the arthroscope, the surgeon carefully cuts away damaged cartilage and repairs surrounding tissue with stitches or glues. At the end of the procedure, he or she removes the instruments, sutures the skin incisions, and dresses the shoulder. The patient is brought to another room so nurses can monitor vital signs and recovery from the anesthesia.
Frozen shoulder surgery has a very high success rate. Patients are usually instructed to rest for about one week, and then begin attending physical therapy sessions to rebuild strength and flexibility. A soft shoulder wrap may be suggested when returning to regular physical activity to provide extra support to the healing joint.