Abstract
While the definition of “stiffness” after shoulder arthroplasty remains controversial, loss of range of motion in the post-arthroplasty setting can be a disabling functional complication. Fortunately, the incidence of post-operative loss of both active and passive range of motion is relatively less common following shoulder replacement procedures. Certain pre-operative diagnoses (proximal humeral fracture, capsulorraphy arthropathy, revision arthroplasty) are associated with post-operative soft tissue contractures. Certain medical comorbidities (diabetes, inflammatory arthropathy) are associated with periarticular capsular adhesions at the intracellular level.
Management of the “stiff” shoulder arthroplasty must account for several confounding variables:
Appropriateness of diagnosis leading to arthroplasty
Humeral and glenoid implants (size, version, hemi vs TSA vs RSA)
Bone variables (fracture, bone loss/erosion)
Soft tissue variables (rotator cuff, glenohumeral capsule)
Patient comorbidities
Techniques for management include soft tissue contracture release (manipulation, arthroscopic, open) and component revision.
