Essential Surgical Technique for Arthroscopic Capsular Release in the Treatment of Shoulder Stiffnes

Full video article: http://surgicaltechniques.jbjs.org/content/5/3/e14

Among many treatments for shoulder stiffness, which is a common debilitating condition, arthroscopic capsular release is an effective surgical method for patients who have not responded to conservative treatment1-3, as it provides visual control of the capsular release with a lower risk of potential traumatic damage than manipulation under anesthesia4,5. In addition, the accompanying shoulder pathology can be examined and treated with a simultaneous capsular release. Even though capsular release has shown favorable results, there have been many controversies regarding the extent of the release. The release of the rotator interval tissue is known to increase the range of flexion and external rotation6. Besides the rotator interval, release of the subscapularis tendon7, inferior capsule8, or global capsule9 can improve elevation and internal rotation, as well as external rotation. A posterior capsular release to improve internal rotation is controversial, with some authors advocating it10,11 and others stating it will not improve outcome compared with anterior release alone5,12,13.

In the present report, we demonstrate a simple way to release the anterior and inferior capsule, including the removal of rotator interval tissue, without incurring the morbidity of a posterior capsular release. The whole procedure is represented in seven steps.

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