Release of adhesions surgery
Release of adhesions is a type of shoulder surgery performed to release contractures and improve function in stiff shoulders that result from frozen shoulder syndrome. Frozen shoulder occurs when the strong connective tissue (capsule) surrounding the shoulder joint thickens and becomes too tight. These thick, stiff bands of tissue are called adhesions. At the same time, the synovial fluid that keeps the joint lubricated during movement begins to dissipate. Pain and lack of motion in the shoulder are the most prominent symptoms of frozen shoulder. Release of adhesions will improve the painful symptoms.
There are two types of surgery for the release of adhesions in the shoulder:
- Shoulder manipulation – Shoulder manipulation is a non-invasive procedure. After the patient is put to sleep with local anesthesia, the doctor or surgeon will forcibly move the shoulder in its normal range of motion. This forced movement causes the shoulder capsule and scar tissue to stretch or tear. The manipulation will decrease the stiffness and increase the range of motion in the shoulder.
In most cases, anti-inflammatory medication and a local anesthetic are injected into the shoulder once the shoulder manipulation is complete. Physical therapy follows the treatment to help the patient maintain mobility in the shoulder. Most patients will experience a dramatic increase of motion from this procedure as well as a partial or total reduction of pain.
- Shoulder arthroscopy – During this procedure, the surgeon uses an arthroscope to help inspect the inside of the shoulder joint for damage. An arthroscope is a small tube, thinner than a pencil, with a system of lenses, a light and a small video camera. The camera sends real-time images to a video monitor next to the operating table, thus allowing the surgeon to see more detail than is seen with a larger incision (open surgery) and the naked eye.
During the arthroscopic release of adhesions procedure, the arthroscope is inserted into the shoulder joint to inspect the extent of damage to the capsule. Once the adhesions are located, the surgeon will cut through the tight portions of the joint capsule. Shoulder manipulation is often combined with shoulder arthroscopy to obtain maximum results from the release of adhesions.