Shoulder Manipulation Under Anesthesia

• A manipulation under anesthesia is performed after the patient has been put to sleep. It involves moving the arm in certain positions to break up the scar tissue that is causing the shoulder to be stiff. A shoulder arthroscopy is then usually performed. This involves making 2-3 incisions (approximately 0.5 inch long) around the shoulder joint for a camera and various other instruments, such as a shaver tool. A shaver is used to clean up any residual scar tissue bands (known as adhesions) that could restrict shoulder motion. The incisions are closed and dressings applied.
• This surgery is most often performed under general anesthesia with a nerve block, but can be performed with a nerve block and sedation.
• This surgery is usually outpatient, which means the patient will be able to go home the same day.
• Surgery typically lasts about 1 hour.
• Patient are usually set up with a continuous passive motion (CPM) device to use after surgery to prevent recurrent scarring and stiffness.
• It is critical to start physical therapy within a few days of surgery to preserve the range of motion obtained from the surgery.
• The incisions are closed with absorbable sutures and are covered with dressings that can usually be removed 2-3 days after surgery.

• Patients who are not progressing with more conservative treatments, such as physical therapy, steroid injection, or anti-inflammatories
• Patients that want to return to activity, sport, and work as soon as possible
• Patients who develop a frozen shoulder after a shoulder surgery that have failed to progress with physical therapy

Patients will be allowed to move their arms once the nerve block has worn off. Physical therapy should start within a couple of days of surgery. Physical therapists follow a protocol outlined by Dr. Faulkner to help regain shoulder motion and function. Physical therapy and home exercises are a critical part to a patient’s outcomes and quality of life after surgery.