Surgical treatment for shoulder periarthritis, also known as adhesive capsulitis or frozen shoulder, is considered when conservative treatments such as physical therapy, medications, and corticosteroid injections have failed to provide adequate relief. The primary goal of surgery is to release the tight, scarred tissue surrounding the shoulder joint to improve range of motion and reduce pain. Here are the main surgical options:
1. Arthroscopic Capsular Release:
- A minimally invasive procedure where the surgeon uses a small camera (arthroscope) and specialized instruments to cut the tight ligaments and release the scar tissue inside the shoulder joint.
2. Manipulation Under Anesthesia (MUA):
- The surgeon manually forces the shoulder to move while the patient is under general anesthesia, breaking up the scar tissue and increasing the range of motion. This is often done in conjunction with arthroscopic release.
3. Open Capsular Release:
- A more invasive procedure where the surgeon makes a larger incision to access the shoulder joint and manually release the tight capsule and ligaments.
4. Shoulder Joint Distraction:
- A technique that involves distracting the shoulder joint to stretch the capsule and improve range of motion, often used in conjunction with other surgical techniques.
Postoperative care typically includes physical therapy to help regain strength and mobility in the shoulder. The success of surgery depends on the severity of the condition, the patient's overall health, and adherence to postoperative rehabilitation. It is important for patients to consult with an orthopedic surgeon to determine the most appropriate surgical option based on their specific needs and symptoms.
