Arthroscopy Techniques (Mar 2024)

Arthroscopic Management of Arthrofibrosis After Hemiarthroplasty for Proximal Humerus Fracture Dislocation

  • Mikalyn T. DeFoor, M.D.,
  • Daniel J. Cognetti, M.D.,
  • Andrew J. Sheean, M.D.,
  • Robert U. Hartzler, M.D.

Journal volume & issue
Vol. 13, no. 3
p. 102883

Abstract

Read online

Poor functional outcomes after hemiarthroplasty for proximal humerus fractures are common, yet revision surgery is relatively rare. Arthroscopic treatment for postoperative stiffness can be considered in the setting of functional limits to glenohumeral range of motion impacting activities of daily living after adequate conservative treatment with physical therapy and in the setting of healed, well-positioned tuberosities and humeral components. This Technical Note illustrates a stepwise approach to an arthroscopic lysis of adhesions and capsular release for the treatment of arthrofibrosis of the shoulder. The advantages of this technique include an alternative approach to entering the glenohumeral joint under direct subacromial visualization and a 2-posterior portal approach to the inferior and anteroinferior capsule, which can be challenging to achieve in the setting of severe postsurgical arthrofibrosis.