What frozen shoulder is
Frozen shoulder, also called adhesive capsulitis, is a condition in which the capsule of connective tissue surrounding the shoulder joint becomes inflamed, thickened and tight. As the capsule contracts, the shoulder loses movement in every direction and the stiffness is usually accompanied by pain, which is often worst at night.
The condition typically moves through overlapping phases: a painful "freezing" phase, a stiffer but less painful "frozen" phase, and a gradual "thawing" phase as movement returns. For many people the condition settles over time with non-surgical care, and surgery is not required. You can read more on our frozen shoulder page.
When surgery is considered
Non-surgical management is the usual starting point and may include analgesia, a guided physiotherapy programme and corticosteroid injection. Surgery is generally only considered when the shoulder remains stiff and painful despite a reasonable period of non-surgical treatment, and when the loss of movement is interfering with sleep, work or daily activities.
The aim of surgery is to release the tightened capsule so that movement can be restored, after which rehabilitation does much of the work in maintaining the range of motion gained in theatre.
The arthroscopic 360° release
Dr Kenneth Cutbush has extensive experience with arthroscopic frozen shoulder release surgery and, together with colleagues, contributed to the development of a minimally invasive technique known as the frozen shoulder 360° release. Rather than releasing only part of the capsule, the technique addresses the contracted capsule circumferentially, through a full 360 degrees, using keyhole (arthroscopic) instruments.
Further detail on the procedure itself is available on our frozen shoulder release page.
What the published work reports
A recent paper co-authored by Dr Cutbush describes a reproducible surgical technique for a 360° release. Published series report that the technique was safe and reliable, with high levels of patient satisfaction. Individual results vary.
Extensive capsular releases of this kind were long thought to carry a high risk of complications. In the series described in that paper, no such complications were reported. As with any shoulder operation, a release still carries risks that are worth discussing in detail before deciding to proceed, and our surgery FAQs cover the general questions most people have.
The full paper is available at doi.org/10.33548/SCIENTIA1127.
Next steps
If your shoulder has become progressively stiff and painful and has not improved with physiotherapy, an assessment can clarify whether you have a frozen shoulder or another cause of stiffness, such as shoulder arthritis. You can find out what an appointment involves on our consultation page, and what to bring on the consultation FAQs page.