University Times

Orthopaedic surgeons at the University of Pittsburgh Medical Center (UPMC) say that arthroscopic surgery is a favorable treatment for patients with shoulder capsular stiffness and immobility that resists conservative, non-surgical treatment.

Jon J.P. Warner, assistant professor of orthopaedic surgery and director of shoulder surgery at UPMC's Center for Sports Medicine, reported the finding, based on a four-year UPMC study, at the annual conference of the American Shoulder and Elbow Surgeons/American Academy of Orthopaedic Surgeons in Orlando last month.

The shoulder capsule is the sac-like envelope enclosing the shoulder's ball-and-socket joint. Capsular stiffness and immobility can be caused by traumatic injury, diabetes mellitus and other conditions.

The WPIC study shows arthroscopy as an effective and reliable treatment that improves shoulder joint motion with minimal surgical morbidity, and one that can be easily converted to an open surgical procedure if necessary.

The arthroscopy usually takes about 90 minutes. The scar tissue causing the stiffness and immobility is released using instruments placed through several incisions, each less than one centimeter long. The patient remains hospitalized for 48 hours while undergoing physical therapy. After an additional three to five weeks of supervised therapy as an outpatient, the patient can continue therapy on his or her own. Motion gain and pain relief usually are seen within one week of therapy.

Patients should be treated first with supervised physical therapy prior to trying arthroscopy, Warner said.