Strategic Tips and Tricks for Frozen Shoulder Arthroscopic Management

Description

In this educational video, Dr. Sergio Rowinski, an expert in shoulder surgery from Sao Paulo, Brazil, provides valuable insights and techniques on managing adhesive capsulitis, commonly known as frozen shoulder, through arthroscopic surgery. He begins by explaining that while most cases improve with non-operative management, some patients do not experience relief after extensive treatment and might benefit from surgical intervention.



Dr. Rowinski presents two patient cases as exemplars of successful arthroscopic management. The first involves a 62-year-old man who developed a frozen shoulder post-rotator cuff repair and continued to experience pain and stiffness after 18 months of non-surgical treatment. The doctor details the surgical procedure, illustrating the dense inflammatory tissue and synovitis encountered, and emphasizes the importance of carefully removing adhesions and scar tissue around the shoulder joint to restore mobility.



Throughout the surgery, Dr. Rowinski employs a clear, pedagogical approach, highlighting critical anatomical structures like the biceps tendon, rotator interval, and the subscapularis muscle. He demonstrates the meticulous care needed to avoid potential iatrogenic complications, notably a Bankart lesion, while ensuring sufficient release of the fibrovascular tissues to improve the range of motion.



The second case features a 68-year-old man with a stiff shoulder following a proximal humerus fracture. Dr. Rowinski discusses the pre-operative assessment, showcasing the range of motion limitations, and continues by demonstrating the surgical technique to relieve adhesions effectively.



The video emphasizes key takeaways for fellow surgeons, including the necessity of patience and precision during arthroscopy, the role of instruments like the shaver, and the potential benefits of additional portal access for optimal visualization and treatment. Dr. Rowinski concludes by encouraging viewers to subscribe, comment, and engage with the content, urging them to "never stop flying." The quality of the footage reflects its production time, around 2008-2009, yet the instructional value remains significant for practitioners in the field.

DOI: 10.1302/3114-221012

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