Arthroscopic capsular release for posttraumatic shoulder stiffness

Severe pain and shoulder stiffness after soft tissue trauma or fracture is a major cause of dysfunction. Some patients may have residual, resistant, significant shoulder stiffness that causes long-term functional impairment. This study reports the results of arthroscopic capsular release in 21 patients who presented with posttraumatic stiff shoulders resistant to nonoperative therapy. They underwent arthroscopic circumferential capsular and subacromial release of adhesions under interscalene block, followed with immediate regular physiotherapy. A highly significant improvement in the range of motion (ROM) was achieved immediately postoperatively (P <.0001). At 6 months, a mean 48% of the ROM gain was lost.

Thereafter, ROM steadily improved to a mean net gain of 110% compared with the immediate postoperative time (mean follow-up, 33 months). Most patients (95%) expressed satisfaction with their outcome. Arthroscopic capsular release is a useful treatment for resistant posttraumatic stiff shoulder, particularly to alleviate of pain and restore a functional ROM.

(J Shoulder Elbow Surg 2008;17:410-414.)