Capsular release is a surgical intervention performed for joint stiffness conditions, which may be attributed to an excessively thick or tight joint capsule. This procedure is most frequently used in the shoulder, especially in the case of adhesive capsulitis, or frozen shoulder. Nevertheless, capsular release can be done on other joints like the knee or elbow in case of stiffness or immobility.

Indications for Capsular Release

It is usually done when other treatments such as physiotherapy, medication, and corticosteroid injections have failed in managing the symptoms. Common indications include:

·        Adhesive Capsulitis (Frozen Shoulder): It has been characterized by ongoing shoulder joint stiffness and pain, which restricted movement.

·        Post-Surgical Stiffness: Stiffness after surgery or injury.

·        Inflammatory Conditions: This include conditions such as arthritis whereby the joint capsule becomes stiff and does not allow free movement.

Procedure Overview

The capsular release procedure can be done either arthroscopically or through an open procedure but the arthroscopic method is more popular since it is less invasive and results in minimal post-operative discomfort and quicker recovery.

Arthroscopic Capsular Release:

1.     Anesthesia: The patient may receive regional or general anesthesia.

2.     Incisions: The skin is then cut in several places around the joint.

3.     Arthroscope Insertion: A small camera, known as an arthroscope, is used to see inside the joint.

4.     Capsule Cutting: Certain tools are employed to trim and free up the contracted portions of the joint capsule.

5.     Removal of Scar Tissue: If there are any adhesions or scar tissue that may be causing stiffness, these are released.

6.     Closure: Wounds are then stitched or stapled before a sterile dressing is placed on the area.

Recovery and Rehabilitation

Recovery from capsular release includes physiotherapy to improve mobility and muscle tone. The specific rehabilitation protocol can vary but generally includes:The specific rehabilitation protocol can vary but generally includes:

·        Early Mobilization: Gradual mobility exercises are started right after surgery to avoid the formation of scar tissues and to sustain the results obtained through surgery.

·        Strengthening Exercises: Gradually, as the healing process goes on, muscle strengthening exercises are introduced.

·        Pain Management: Adjuvant pain and anti-inflammatory drugs might be given to control pain after the procedure.

·        Follow-up Care: Continued visits to the orthopedic surgeon or physical therapist to assess the recovery and modify the treatment regimen as needed.

Risks and Complications

While capsular release can be highly effective, it carries potential risks, including:While capsular release can be highly effective, it carries potential risks, including:

·        Infection: Like any other surgical procedure.

·        Nerve or Blood Vessel Damage: This is due to the fact that these structures are in close contact with the joint capsule.

·        Re-stiffening: The joint may become stiff again if the postoperative rehabilitation is not well observed.

·        Pain: Although the pain is generally less in the long term, it may still be present on a chronic basis.

Effectiveness

The outcome of capsular release is generally determined by the condition being treated, the degree of stiffness, and the patient’s commitment to physiotherapy. Most of the patients have reported a general improvement in pain management and joint flexibility.

Conclusion

Capsular release is an effective surgical procedure for patients who have joint stiffness that has not improved with non-operative measures. It is intended to help achieve functional recovery and relieve pain, allowing for the resumption of normal activities. Adherence to postoperative care and physiotherapy is paramount for the best results.