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Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek
the advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
medical condition.
Adhesive Capsulitis—Arthroscopic Surgery
(Frozen Shoulder—Arthroscopic Surgery)
Pronounced: ad-HEE-siv cap-soo-LIGHT-iss
by
Mary Cresse
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
Reasons for Procedure
This procedure is done to:
- Break up scar tissue
- Relieve pain
- Restore range of motion in the shoulder joint
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
- Damage to soft tissue
-
Fracture
- Infection
- Instability or stiffness in joint
- Nerve injury
- Pain
- Reaction to anesthesia used
Some factors that may increase the risk of complications include:
-
Certain medicines—especially those that increase bleeding (eg,
aspirin
)
- Previous shoulder surgery (may cause damage)
- Recent or chronic illness
- Smoking
or alcohol use
What to Expect
Prior to Procedure
Your doctor may do the following:
- Blood and urine tests
- MRI scan
—a test that uses magnetic waves to make pictures of structures inside the body
- Physical exam
- X-ray
—a test that uses radiation to take a picture of structures inside the body, especially bones
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
-
Blood thinners, such as
clopidogrel
(Plavix) or
warfarin
(Coumadin)
- Aspirin
or other anti-inflammatory drugs
Leading up to the procedure:
- Arrange for a ride to and from the hospital. Also, arrange for help at home after the surgery.
- If told to do so by your doctor, on the day of the surgery, shower using a special antibacterial soap. Do not use deodorant.
- 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.
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
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:
-
Resume your regular diet when you are ready. You may need to start with a
clear liquid diet
.
-
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
.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Be sure to follow your
doctor’s instructions.
- Change the dressing.
- Ice the swollen area for the first 24-48 hours. Do this for 20-30 minutes at a time.
- Return to the doctor in 7-14 days to have your stitches removed.
- Sleep sitting up or in a recliner. Place a pillow behind your elbow.
- Take pain medicine. If you have a pain pump, this will be removed in 1-2 days.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
- Cough, trouble breathing, or chest pain
- Pain becomes worse or swelling increases
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
- Severe nausea or vomiting
- Signs of infections, including fever and chills
- Tingling or numbness that will not go away, especially in arms and hands
Last reviewed: December 2011
by John C. Keel, MD.
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 Publishing DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php
. 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:
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-
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.
Accessed
December 4, 2008.
-
Examination under anesthesia. University of Washington Orthopaedics and Sports Medicine website. Available at:
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-
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-
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.
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-
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-
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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.
-
Role of massage in scar therapy. EBSCO Publishing Consumer Health Complete website. Available at:
http://www.ebscohost.com/thisMarket.php?marketID=14
. Updated March 2002. Accessed November 18, 2008.
-
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-
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.
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-
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-
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