Manipulation under Anaesthetic (MUA) for release of shoulder contracture
with/without Arthroscopic release of shoulder contracture and Injection of Steroid
This technique is used in the treatment of frozen shoulders. A shoulder becomes frozen when the soft tissues around the joint become tight and short (i.e. contracted). This prevents the shoulder from moving and leads to the pain and stiffness with which you are familiar.
The problem may resolve over time but it can take up to two years.
The Operation
The aim of the manipulation is to reduce the recovery time by stretching the joint by the surgeon in a controlled manner, to gain full range of movement. This is combine with an injection of local anesthetic and steroid to reduce inflammation and pain.
There may be need to proceed and perform further arthroscopic release of the contracture, if the manipulation is not successful. This operation is done by key hole surgery; usually through two or three 5mm puncture wounds. It involves examination of the shoulder joint using a tiny telescope with television camera introduced through a key hole. It involves cutting of the tight (contracted) tissues in the shoulder with a special electro-cutting/radio frequency device to release the contracture.
The operation is performed under general anesthetic and a nerve block (injection in your neck or upper chest) that will make your arm feel numb for 8-12 hours after surgery. This is to allow you to mobilize your shoulder immediately after surgery without pain. When this wears off, the shoulder may well be sore and you will be given painkillers to relieve the pain.
Complications
As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation.
They include:
Complications relating to the anaesthetic.
Infection.
Injury to the nerves or blood vessels around the shoulder. Sometimes, the nerves become irritable resulting in pain and stiffness in the upper limb,a condition called reflex sympathetic dystrophy (RSD).
Fracture: The upper arm bone (humerus) breaking. This is extremely rare.
Failure of the operation in improving pain or movement in your shoulder. There should be about 75% improvement in symptoms in the first four to six weeks.
Prolonged stiffness and or pain.
A need to redo the surgery.
If you require further information please discuss with the doctors either in clinic or on admission.