All arthroscopic release of the glenohumeral joint for severe frozen shoulder: initial glenohumeral visualization through trans-cuff portal.

BACKGROUND

In recent two decades, a novel minimally invasive technique for resistant frozen shoulder, arthroscopic glenohumeral release, has been popularly practiced. However, by far one key point, although being well recognized, has not been tackled at all during the procedure-that is how to safely and smoothly insert the arthroscope into contracted and restricted glenohumeral joint when MUA cannot be performed or work, especially the severe stiff shoulder.

MATERIALS AND

METHODS

We have developed a new strategy for the treatment of the problem-initial glenohumeral visualization through musculotendinous junction of supraspinatus. Using this accessory portal, the posterior glenohumeral joint could be viewed and an accurate posterior portal was instituted through which the arthroscope could be placed into glenohumeral joint definitely parallel to the glenoid face without injuring the articular cartilage; the arthroscope and electrocautery could move more freely to favor subsequent sequential glenohumeral release as well. In this report we present this technique in detail and intraoperative results in 27 consecutive severe frozen shoulders.

RESULTS

The success rate of initial glenohumeral placement of arthroscope through trans-cuff portal was 100 % without glenoid or humeral head cartilage injury.

CONCLUSIONS

For severe frozen shoulder, initial glenohumeral visualization through trans-cuff portal is practical, safe and reproducible.

LEVEL OF EVIDENCE: Level IV, Case Series, Treatment Study.