Capsular Release Surgery

Capsular release surgery is arthroscopic (keyhole) surgery involving the release of the tight capsule seen in frozen shoulder.  The shoulder joint is wrapped in a fibrous sac called the shoulder capsule and surrounded by a liquid called synovial fluid, which helps the bones rotate more smoothly.  Occasionally, the capsule becomes thicker and tighter, putting pressure on the connective tissues in your shoulder and affecting its movement.  The nerves in the joint can also be pinched or compressed, causing pain and numbness.

For further information on frozen shoulder, click here

 

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Pre-Operative Assessment

In the days leading up to your surgery, you will need to organise travel arrangements tor getting to your appointment and getting home afterwards. You will be asked to come in for a pre-operative assessment.  The nurse will evaluate your state of health and organise the necessary tests.  This may include urine tests, blood tests and imaging such as an X-ray.

Discharge planning will start at this time. If you require any extra help following the procedure, now is the time to discuss this to avoid delays when being discharged.

 

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Procedure

Manipulation under anaesthesia has been the traditional form of surgery used for frozen shoulder.  This method involves freeing the shoulder by manipulating it under general anaesthesia; this has been an effective procedure for many people suffering with frozen shoulder.  However, capsular release surgery is performed with increased precision via keyhole surgery.  Results are successful in over 80% of patients and offer quicker pain relief results than manipulation.  Capsular release surgery is also considered safer and more effective than manipulation for people who have developed a stiff (frozen) shoulder following an injury, fractures and trauma, along with those diagnosed with diabetes.

 

Capsular release surgery is a minimally invasive procedure carried out through small incisions in the skin, using a miniature camera (arthroscope) to see inside the shoulder joint.  Minimally invasive surgery allows the body to recover quickly and the small incisions help reduce the chance of infection.

 

The procedure is carried out as a day case under a general anaesthetic, meaning you can go home on the day of your operation.  In some cases, patients who have other medical conditions may be required to stay in overnight.  You will need to organise someone to collect you from the hospital and stay with you overnight.  The surgery is performed as a keyhole (arthroscopic) surgery using a camera linked to a monitor that enables the surgeon to look inside the shoulder joint.  There will be 2 – 3 small scars on the front, back and side of the shoulder.  This allows the surgeon to assess the shoulder joint and then use tiny instruments to release the capsule where it is most tight. The Anaesthetist may put an injection in to the side of the neck to numb the shoulder and can last up to 24 hours.

 

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Post-Operative Recovery

Following capsular release surgery, the physiotherapist will provide you with exercises to help you begin moving your shoulder.  You will probably be provided with painkillers following the surgery to take home with you.  Make sure you discuss your return to work after the procedure with your consultant.

 

It is crucial that you follow the advice the hospital and the consultant give you.  Do not drive until you are confident that you can control your vehicle.  Always check with your insurance policy and with your doctor before driving.

 

Following surgery, you will likely experience some discomfort, swelling and bruising in your arm.  Sometimes your shoulder may need to be held in a special splint to keep the capsule stretched while it heals.  However, it is important to start moving your joint as soon as possible following the operation.  This will help prevent scar tissue from building up inside your shoulder which may hinder progress.

 

A physiotherapist will guide you through the exercises, massage and stretches that you need to do to help rebuild strength and maintain flexibility and movement following surgery.  Full range of motion it can take 3 months or longer, provided you continue with exercises provided to you.

 

A follow up appointment is made approximately 4 – 6 weeks following your procedure.  The amount of physiotherapy required will depend on individual needs.

 

After approximately 3 weeks, movements below shoulder height should be more comfortable.  You should have almost full range of motion although you may experience some discomfort when moving the arm above the head and when lying on the affected shoulder.

 

Approximately 3 months following your procedure, your symptoms should be roughly 80% better.  It can take around 6 – 9 months to fully recover with improvements continuing for up to a year following the procedure.

 

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Risks and Complications

Capsular release surgery is typically considered a safe procedure.  However, as with most types of surgery, there are risks and complications that can occur. These include:

 

• Anaesthetic reaction
• Bleeding
• Chest infections
• Blood clots
• Pain

 

Complications related to capsular release surgery include:

 

• Re-stiffening (your physiotherapist should provide you with exercises to minimise this risk)
• Infection at the surgical wound
• Nerve damage

 

It is important you seek medical advice if you experience any of the following:

 

• A significant increase in pain
• Dramatically less shoulder movement
• Swelling or inflammation around the wound
• Excessive wound leakage/discharge
• Flu like symptoms such as a high temperature and feeling generally unwell

 

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Outlook

Surgery is generally not the first call to action to treat frozen shoulder.  You should consider all options before deciding on surgery.  Arthroscopic capsular release surgery is a typically successful procedure with 85% of patients showing significant improvements in range of motion and pain.  In some cases, people will require further treatment, with people diagnosed with diabetes tending to show more resistance to treatment.

 

Although it is rare for frozen shoulder to reoccur on the same side, it is more common for patients to develop frozen shoulder on their opposite elbow.

 

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Need Help?

Capsular Release major repair surgery is available at One Ashford Hospital. We also offer a number of other procedures for shoulder and elbow conditions, including shoulder replacement surgery, SLAP repair and elbow release surgery.  We can book you in to see a specialist Orthopaedic Shoulder Surgeon for an initial consultation, usually within 48 hours.

 

One Ashford Hospital is well placed to see patients from Ashford, Canterbury, Maidstone, Dover, Folkestone and all surrounding areas.  To book an appointment, call the hospital direct on 01233 364 022 or email here.

 

You can use your private medical insurance or pay for your Capsular Release Surgery treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Ashford Hospital

Why One Ashford Hospital

• Access to leading Consultants within 48 hours*
• 0% and low finance options**
• Competitive fixed-price packages
• Modern purpose-built hospital
• Private, spacious, ensuite rooms
• Specialist Physiotherapy and nursing teams
• Little waiting time for surgery
• Calm, dignified experience

*Dependent on Consultant availability
**Terms and conditions apply

Contact us and find out more

If you are based in and around Kent, Maidstone, Dover, Canterbury or Folkestone and would like to visit the One Ashford Hospital please click here