Manipulation Under Anaesthetic / Arthroscopic Release of Shoulder Contracture

Arthroscopic release is performed for post traumatic (post fracture) and post surgical stiffness.

A Manipulation Under Anaesthetic (MUA) and/or Arthroscopic release are performed for primary frozen shoulder (adhesive capsulitis), but not usually in the acute phase.

The operation is performed under general anaesthetic with injection of local anaesthetic and steroid into the joint. Full range of motion is achieved operatively unless otherwise stated.
The procedure is done as a day case except where the patient has diabetes or other systemic problems where overnight stay may be indicated.

Protocol

The patient is seen prior to discharge by the physiotherapist when passive and active range of motion is begun. It is important that the joint is taken through all planes of movement.
The patient is discharged with exercise and advice on pain control.
A physiotherapy appointment must be pre-arranged for the following day.

Aims of Physiotherapy

Restore FULL range of movement as quickly as possible through passive and active assisted exercise, maintain this range
Encourage resumption of ADL immediately.
Exercising in water is particularly beneficial
Strengthen rotator cuff as appropriate

3 Weeks

The patient attends hospital for review
The patient will continue with physiotherapy if indicated and is usually discharged at this stage.

3 Months

The patient attends hospital for review and is usually discharged at this stage.

Return to Functional Activities

Driving 1 week
Return to Work Dependant on the patient’s occupation
Golf 6 weeks, (but not driving range)
Racquet Sports Sport specific training when comfortable Competitive play after 3 months
Lifting as able