Arthroscopic Capsular Release (Frozen Shoulder)
A minimally invasive procedure to relieve pain and improve mobility in a frozen shoulder
Shoulder arthritis can affect the glenohumeral joint (ball-and-socket joint) or the acromioclavicular joint (where the collarbone meets the shoulder blade). Surgical options are often considered when non-surgical treatments such as medications, physical therapy, or injections do not sufficiently relieve symptoms.
Common Reasons for Surgery
- Severe pain limiting daily activities, such as lifting or reaching.
- Loss of shoulder mobility due to joint stiffness.
- Joint deformity or grinding sensation caused by cartilage loss.
- Failure of non-surgical treatments to provide adequate symptom relief.
Goals of the Procedure:
- Reduce pain and inflammation in the shoulder.
- Restore or improve shoulder mobility and function.
- Preserve or enhance the quality of life.
Preparation for Surgery
Preparation is essential to optimise surgical outcomes and ensure a smooth recovery process.
Steps in Preparation:
- Pre-Surgical Evaluation: Dr Ben McGrath will conduct a thorough assessment, including medical history, physical examination, and imaging studies such as X-rays, CT scans, or MRIs.
- Medication Adjustments: Certain medications, such as blood thinners, may need to be paused before surgery.
- Lifestyle Changes: Quitting smoking, maintaining a healthy weight, and engaging in light exercises may improve surgical outcomes.
- Pre-Surgical Instructions: Patients may be advised to fast before the procedure and arrange post-surgery transportation and care.
What Happens During the Surgery?
The type of surgery depends on the severity of arthritis and the specific needs of the patient. Common procedures include shoulder replacement (arthroplasty) and arthroscopic debridement.
Surgical Steps:
- Anaesthesia: Surgery is performed under general anaesthesia or regional block anaesthesia for pain management.
- Joint Access: A minimally invasive or open surgical technique is used to access the shoulder joint.
- Repair or Replacement: Depending on the procedure, damaged cartilage and bone may be removed, and an artificial joint implant may be placed.
- Closure: The incision is carefully closed, and a dressing is applied to protect the site.
The duration of surgery varies based on the complexity of the case.
Understanding the Risks
While shoulder arthritis surgery is generally safe, it carries some risks, which will be discussed with you prior to the procedure.
Common Risks:
- Infection at the surgical site.
- Swelling and stiffness in the shoulder.
- Temporary nerve irritation or damage.
Rare but Serious Risks:
- Blood clots in the arm or lungs.
- Implant-related complications, such as loosening or dislocation.
- Reduced range of motion if scar tissue forms excessively.
Dr McGrath employs advanced surgical techniques and post-operative care protocols to minimise these risks.
What to Expect After Surgery
Immediate Post-Operative Care:
- Pain management through medications and cold therapy.
- The use of a sling or shoulder immobiliser to support healing.
- Initial physiotherapy to promote gentle movement and prevent stiffness.
Discharge Instructions:
- Guidance on wound care and signs of potential complications.
Recommendations for physical activity restrictions and follow-up appointments.
Rehabilitation and Recovery
Rehabilitation is crucial for a successful recovery and optimal function.
Phase 1: Early Recovery (Weeks 0–6)
- Focus: Pain management, wound healing, and gentle range-of-motion exercises.
- Use of a sling or immobiliser may be required during this phase.
Phase 2: Intermediate Recovery (Weeks 6–12)
- Focus: Gradual strengthening exercises under the guidance of a physiotherapist.
- Increased shoulder mobility through supervised movements.
Phase 3: Advanced Recovery (Months 3–6)
- Focus: Restoring function for daily activities and low-impact exercises.
- Continued physiotherapy to build strength and prevent stiffness.
Long-Term Outcomes
Surgical management of shoulder arthritis may result in significant improvements in pain, mobility, and quality of life. Long-term outcomes depend on factors such as the type of procedure, adherence to rehabilitation, and overall health.
Expected Improvements:
- Reduction in pain and inflammation.
- Improved shoulder strength and function.
- Enhanced ability to perform daily tasks and recreational activities.
Follow-up appointments with Dr McGrath will help monitor your recovery and address any concerns.