Arthroscopic capsular release of the shoulder is indicated in individuals who have persisting shoulder stiffness and pain which has failed to respond to a course of physical therapy and intraarticular injections. Arthroscopic release allows a more gentle manipulation of the shoulder and consequently a more rapid return of function to the shoulder during the early post surgical rehabilitation phase.
Day of Surgery
Patients are placed in an arm sling. Postoperative pain is managed with a scalene block and a pain catheter is left in the joint for continuous inflow of local anesthetic for 24 to 48 hours after surgery. Arrangements are made for a home continuous passive motion machine, which is initiated on the day of surgery while the block is still in place. The patients are instructed by the vendor how to operate the machine and they are encouraged to continually make adjustments as they advance their range of motion. Patients are instructed to discontinue their sling as soon as tolerable in an attempt to resume normal function of the shoulder. Patients are instructed to remove their dressing after the pain pump is empty. The portal sites can be covered with Band-aids and the Steri-strips are left in place. Patients attend daily physical therapy for the first 2 weeks after surgery. The therapy is initiated immediately after surgery.
First Postop Visit: (7 to 10 days)
Patients are evaluated for gains in range of motion. Pain should be well controlled at this phase. Physical therapy can be reduced to 3 times a week. Patients are rapidly gaining full active motion and a home program can be utilized with weekly visits to the therapists for treatment and measurement.
Second Postop Visit: (5 to 6 weeks)
Patients should be near full range of motion at this point with minimal pain. Individuals who are progressing slowly may continue in physical therapy, however, many patients will discontinue therapy at this point and continue on a home maintenance program.