Question:Next week I'm going to have arthroscopic surgery for a frozen shoulder. The surgeon has explained everything to me. Just the front part of my shoulder capsule will be cut. I'm wondering if they don't release the back part, too will I still get my full motion back?
Answer:Frozen shoulder also known as adhesive capsulitis is used to describe a loss of shoulder motion caused by changes in the shoulder joint capsule. The capsule is an envelope of connective tissue that surrounds the shoulder joint.
Injury and inflammation can start the process leading to adhesive capsulitis. Painful motion causes the person to stop moving the shoulder, and it gets bound down. It can also occur as a result of other conditions such as diabetes, heart disease, and lung disease.
It was once thought that changes throughout the capsule are what caused the tightness. It is true that with a frozen shoulder, there is fibroplasia throughout the capsule. Fibroplasia refers to the formation of fibrous scar tissue.
But surgeons found that by releasing just the anterior (front) part of the capsule restores shoulder motion. Further research showed that a particular protein called vimentin is what really leads to anterior contracture (tightness) of the capsule.
By releasing the anterior capsular structures, motion is restored throughout the joint for most people. Frozen shoulder can range from loss of external rotation and abduction (moving the arm away from the body) to a complete loss of all motion. More extensive surgery may be needed for more extreme cases.Hans K. Uhthoff, MD, FRCSC, and Pascal Boileau, MD. Primary Frozen Shoulder. In Clinical Orthopaedics and Related Research. March 2007. No. 456. Pp. 79-84.
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