The shoulder joint is enveloped by a layer of tissue called the capsule. This capsule protects and controls the shoulder’s motion. In some patients, especially diabetics, the capsule may thicken and become less compliant. This results in the condition known as frozen shoulder.
This condition is more common in middle aged females and in diabetics. The condition starts slowly and over time makes it hard for the patient to fully move their shoulder. Dull pain can be felt especially in the extremes of motion.
Some other causes for adhesive capsulitis include thyroid disease, Parkinson’s disease and prolonged immobilization. Adhesive capsulitis is diagnosed on physical exam. An x-ray or MRI may be ordered to rule out any other conditions such as arthritis or rotator cuff disease.
What is shoulder arthroscopy?
Until recently, shoulder surgical procedures were done by making large incisions over the operative area. This resulted in somewhat large scars and significant discomfort after surgery. With the advancement of optical and orthopedic technology, we are now able to perform most procedures in the shoulder by making very small incisions and using a camera (arthroscope) to view the inside of the shoulder and fix it. Every year, new instruments are introduced which make arthroscopic surgery easier and more successful. Dr. Anthony Romeo has been very instrumental in the introduction and design of many of the shoulder arthroscopic procedures performed today. He performs over 300 shoulder arthroscopies a year.
How is it done?
Prior to surgery, most patients are given a numbing block in their shoulder and neck to anesthetize the nerves connected to the shoulder. This makes the patients require much less anesthesia and makes it possible for them to go home the same day and have a more comfortable recovery.
After anesthesia is administered, the patient is either placed in a sitting position (beach chair) or lying-on-the-side position (lateral decubitus). This is decided based on the area of the shoulder which requires attention.
Two to four small (under ¼”) incisions (portals) are made around the shoulder. The arthroscope (camera) is then introduced in the main shoulder joint. Sterile salt water is used to inflate the joint and allow safe placement of instruments in the shoulder. Small instruments are placed to diagnose any abnormalities or tears. Photographs and videos are taken of the different parts of the shoulder to document its condition. Shavers and sutures are utilized to fix any torn or damaged tissues.
At the conclusion of the procedure, sutures are used to close the small portal sites and small band-aids (steri-strips) are placed over the incisions with sterile dressings. When the patient wakes up, they will find a blue cuff over their shoulder which is called a polar-care cuff. This cuff is connected to a cooler filled with ice and circulates cold water to control post-operative pain. In addition, the patient is placed in a sling which helps protect the repair and gives the shoulder comfort and support.
After surgery, you will be transferred to the recovery room. You will remain there for about one hour and then are discharged to home with your family.