Frozen shoulder (adhesive capsulitis) causes pain and severe restriction of motion in the shoulder joint. This stiffness occurs when the connective tissue surrounding the joint, called the capsule, thickens and tightens, forming dense scar tissue. Surgery is typically considered only after several months of non-operative methods, such as physical therapy and corticosteroid injections, have failed to restore adequate mobility. While the time the procedure takes is a primary concern, the total time spent at the hospital is much longer.
Duration Based on Surgical Technique
The time spent in the operating room depends on the specific technique used to address the contracture. The two main surgical methods are Manipulation Under Anesthesia (MUA) and Arthroscopic Capsular Release (ACR). Both procedures focus on restoring movement by breaking up or cutting the restricting scar tissue while the patient is sedated.
Manipulation Under Anesthesia (MUA)
MUA is the faster option, requiring a brief period of anesthesia. In this technique, the surgeon forcibly moves the joint through a full range of motion. This action mechanically tears the scar tissue and adhesions within the shoulder capsule, immediately restoring a greater range of motion. The actual manipulation typically requires less than 10 to 20 minutes under anesthesia.
Arthroscopic Capsular Release (ACR)
ACR is a more involved keyhole surgery performed using a camera and specialized instruments. The surgeon makes small incisions to insert an arthroscope and visually cuts the thickened, tight portions of the joint capsule. This controlled release is often accompanied by gentle manipulation at the end of the procedure. ACR requires more time than MUA due to the setup and the precise cutting of the scar tissue. The time spent under anesthesia typically ranges from 30 to 60 minutes.
Variables Influencing Surgical Timing
The type of procedure sets the baseline time, but several factors influence the final duration in the operating room. The severity of the capsular contracture is a significant factor. A shoulder with dense or widespread adhesions may require a more extensive release, which extends the time needed for the arthroscopic technique.
The surgeon’s experience and specific preferences for instrumentation and technique also play a role in the overall duration. A surgeon who performs the procedure frequently may operate at a more efficient pace. Furthermore, the discovery of concurrent issues, such as bone spurs or tendonitis, may prompt brief, simultaneous treatments. Treating these incidental findings adds minutes to the total surgical time but contributes to a better long-term outcome.
Total Patient Time and Immediate Recovery
The duration of the surgery is a small fraction of the total time spent at the hospital or surgical center. Frozen shoulder surgery is almost always performed on an outpatient basis, meaning the patient is discharged the same day. The pre-operative preparation phase involves administrative tasks, changing clothes, meeting staff, and receiving a nerve block or IV line. This preparation often takes between one and two hours.
Once the procedure is complete, the patient is transferred to the Post-Anesthesia Care Unit (PACU) for immediate monitoring. This phase allows the patient to safely wake up from the anesthesia and allows the medical team to manage post-operative pain. The typical stay in the PACU is approximately one to three hours, depending on the patient’s reaction to the anesthesia and pain control.
Considering the preparation, surgical time, and recovery monitoring, the total time from hospital check-in to final discharge usually spans about four to six hours. Patients are encouraged to begin moving the arm immediately after the procedure, often with a physical therapist present. This immediate post-operative motion is fundamental to treatment success, preventing the re-formation of scar tissue.