Shoulder arthroscopy. Investigations with a fibreoptic instrument.

Ten patients with frozen shoulders and 13 other patients with derangements of the shoulder were examined by arthroscopy. The procedures were performed under anesthesia. A fibreoptic instrument was introduced posteriorly. All patients with frozen shoulders were relieved of their symptoms by the combined procedure of joint distention (with as much as 60 ml of saline) and arthroscopy, with or without manipulation of the shoulder. Three of the 13 cases of imprecisely diagnosed shoulder derangement are described in detail to illustrate refinements in the diagnosis which determined surgical repair in 2 cases and precise local treatment in the other one. All patients, whose shoulders were not manipulated, were discharged to their homes on the day of the procedures. A sling was worn for the first 24 hr and then the patient was placed on a regimen of supervised physical therapy. There was no significant morbidity in these patients. Additional refinements in arthroscopy for the shoulder and increasing expertise in using the techniques will firmly establish arthroscopy as a means for establishing precise diagnoses fro shoulder conditions.