Arthroscopic Circumferential Release for Stiff Reverse Total Shoulder Arthroplasty

Abstract

Stiffness is a well-known complication after reverse shoulder arthroplasty. Although multiple factors may be involved, the main cause for stiffness is rarely identified. Imaging studies frequently are inconclusive in ruling out mechanical or biological causes. Periprosthetic infection should be always suspected, but the absence of major clinical signs and accurate diagnostic tests is frequent. A lack of objective criteria establishing a diagnosis and when to proceed with revision surgery is often present in such cases. Moreover, additional surgical procedures should be carefully evaluated, as they can represent a point of no return. Shoulder arthroscopy plays an increasingly important role in these cases, either as a diagnostic or therapeutic tool. There are no reports about arthroscopy on stiffness after reverse shoulder arthroplasty. In this Technical Note, we describe an arthroscopic technique aimed to identify potential causes of reverse shoulder arthroplasty stiffness. Subsequent circumferential release is described and discussed.

Arthroscopic Management of Stiffness and Anterior Shoulder Pain Following Reverse Shoulder Arthroplasty

“…Aguilar-Gonzalez et al. 18 described a circumferential arthroscopic release to manage stiffness in patients after RSA. However, their technique primarily concentrated on the importance of tissue sampling in multiple areas to evaluate for infection and clearing the subacromial space, rather than the subcoracoid space.…”