Management of the Stiff Shoulder Arthroscopic capsular release for shoulder stiffness: techniques and possibilities

In 1934, Codman first introduced the term “frozen shoulder” to identify a clinical entity difficult to define, to treat, and to explain. Neviaser, in 1945, found thickening and contracture of the capsule, and that the thickened capsule peeled from the humeral head like adhesive plaster from skin. Adhesive capsulitis, also known as frozen shoulder, is a musculoskeletal disorder characterized by pain and restriction of motion of the shoulder joint. In the primary or idiopathic form, no causative finding in the history or examination explains the onset of the disease. Secondary adhesive capsulitis relates to those cases that develop following trauma or surgery. The true incidence of primary adhesive capsulitis in general population varies from 2 to 5 %. 1-3) Yet, despite the large number of patients affected by this condition, our understanding of its etiology is limited. Middle aged people seem to be more at risk, with women more so than men. 1, 2) It often presents bilaterally, but does not seem to affect the same shoulder twice. 4) Comorbidities such as diabetes, 1, 5-7) hypothyroidism, 8, 9)