Frozen shoulder is a common cause of shoulder pain and stiffness. The majority of the patients can be treated conservatively. However, if conservative treatment fails, Manipulation under anesthesia and Arthroscopic capsular release can both be considered as appropriate treatment options. Manipulation under anesthesia is an easy, time- and cost-efficient technique, but is associated with the risk of iatrogenic damage. Arthroscopic capsular release seems to be a safer way to release the joint capsule in a controlled way. Additionally, associated intra-articular pathologies can be identified and treated. A comparison between both procedures was attempted. In Arthroscopic capsular release an anterior portal was established by first introducing a needle into the interval area from outside. Through the anterior portal, a soft-tissue resector was introduced, and then interval synovitis and rotator cuff interval contracture debrided. To restore external rotation, an anterior arthroscopic capsular release was performed beginning just inferior to the biceps tendon and continuing to the inferior edge of the glenoid. If there was continued loss of internal rotation and flexion after an anterior release, arthroscopic release of the posterior capsule was also performed along the glenoid rim as the muscle of the cuff tendons is superficial to the capsule at this level. On completion, subacromial arthroscopy was performed in all patients, and subacromial bursal adhesions were observed and debrided. The results were slightly favorable for Arthroscopic capsular release compared to Manipulation under anesthesia but largely both the treatment modalities were effective in improving the shoulder range of movement and different clinical scores as well as alleviating pain. The difference in improvement of VAS and UCLA score was not significant between the two groups, but Arthroscopic capsular release showed better improvement in range of abduction, external rotation and DASH score

Prateek Jain is currently pursuing specialty training in orthopedic surgery at Government Medical College and Hospital, Nagpur, INDIA as a resident doctor and is interested in various sports injuries and arthroscopic procedures performed over hip, knee and shoulder.