Arthroscopic capsular release is a keyhole operation to divide the thickened, contracted joint capsule in a frozen shoulder, restoring range of motion. It is often combined with manipulation under anaesthesia.
Small incisions are made around the shoulder. An arthroscope is inserted and the thickened, inflamed joint capsule is systematically divided using a radiofrequency device or scissors, starting from the rotator interval and proceeding around the joint. This releases the contracted tissue and immediately improves range of motion. The operation takes 30-45 minutes.
Arthroscopic release is recommended for frozen shoulder that has not responded to prolonged physiotherapy, corticosteroid injection, or hydrodilatation, and is causing severe limitation of daily activities.
Frozen shoulder is self-limiting and resolves over 12-30 months in most patients. Treatment options include physiotherapy, corticosteroid injection (oral or intra-articular), hydrodilatation, and manipulation under anaesthesia alone. Many patients improve without surgery.
Day-case procedure. Standard pre-assessment.
Immediate improvement in range of motion. Combined with intensive physiotherapy, most patients maintain the gains. Results are generally better than manipulation alone, with a lower risk of fracture.
The shoulder is sore for several days after release.
Some patients experience partial recurrence if physiotherapy is not maintained.
Axillary nerve is at risk during inferior capsular release. Rare.
Shoulder joint infection.
Cartilage may be inadvertently damaged during the release.
General anaesthesia with a nerve block. The block allows pain-free exercises immediately after surgery.
Intensive physiotherapy begins on the day of surgery, ideally while the nerve block is active. Home exercises several times daily for at least six weeks. Night splinting may be used. Most patients see significant sustained improvement within four to six weeks.
Physiotherapy from day one. Surgeon review at six weeks.
Arthroscopic release provides a more controlled and complete release with lower risk of fracture compared to manipulation alone. It is particularly advantageous in patients with diabetes, where frozen shoulder tends to be more resistant.
Recurrence after capsular release is uncommon if physiotherapy is maintained. Some patients with diabetes may have a slower or less complete recovery.