Arthroscopic 360° Capsular Release for Adhesive Capsulitis in the Lateral Decubitus Position

Abstract

Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone. Arthroscopic capsular release in the beach-chair position typically requires some degree of manipulation to release the inferior capsule, which is often not visualized intraoperatively. In this technique article and video, we describe and demonstrate a technique of arthroscopic capsular release in the lateral decubitus position, providing a clear view of the inferior capsule, which facilitates a complete, 360° capsular release and mitigates the need for any manipulation under anesthesia.