Only a very small group of patients continue to be very tight and stiff after intensive physiotherapy and a home stretching program. If the stiffness, tightness and inconvenience persist for 3 to 6 months or longer, they may benefit from surgery.
The traditional surgery for frozen shoulder was "manipulation under anaesthesia" or "MUA". The patient is put under a general anaesthetic, and the shoulder is "forced" to its full range. This has an effect of tearing the tight tissues around the shoulder. The surgery takes less than 10 minutes and there are none of the risks of a surgical operation in which incisions are made, such as infection, wound problems, etc. A disadvantage of MUA is that it is slightly uncontrolled, and there is a small risk of breaking the arm bone while trying to force the shoudler up.
Recently, we recommend arthroscopic capsular release. This is a "keyhole" surgery using two 8-mm incisions. The tight tissues are cut under direct camera vision. This results in a very safe and controlled release of the scar tissues. It also has the benefit of being able to make a close inspection of all the structures in the joint.