Case Reports

Dislocation and Instability After Arthroscopic Capsular Release for Refractory Frozen Shoulder

Am J Orthop. 2007 December;36(12):672-674
By
Gobezie R
Pacheco IH
Petit CJ
Millett PJ
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Abstract not available. Introduction provided instead.

Frozen shoulder is a condition of unclear etiology characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.1 Incidence of frozen shoulder is higher in people with diabetes (up to 36% in patients with insulin-dependent diabetes) than in the general population.2-4 As a group, people with diabetes tend to be younger and to have a more painful course of frozen shoulder versus people without diabetes.5 Still, even for people with diabetes, the natural history of this disorder is usually benign, resolving over 1 to 3 years.6

Operative treatment for the frozen shoulder is reserved for patients who do not improve with conservative management and are not in the inflammatory phase of this disease. Arthroscopic release provides a controlled and systematic release of needed structures under direct visualization, without the morbidity of an open approach or having to repair the subscapularis tendon. Despite obvious concerns
about releasing the principal static stabilizers, instability and dislocation have not been reported as complications.

We report the case of a patient with diabetes and frozen shoulder who had failed conservative therapy, closed manipulation, and 2 arthroscopic releases and subsequently developed frank shoulder dislocation. This patient later developed symptoms of shoulder instability. Dislocation and instability after arthroscopic capsular release of a frozen shoulder have not been reported in the English-language literature.
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