Arthroscopic lysis of adhesions post-shoulder arthroplasty improves range of motion: A systematic review

Background: The literature on arthroscopic lysis of adhesions for postoperative stiffness following shoulder arthroplasty is limited, offering insufficient guidance. This systematic review aimed to evaluate the improvement in range of motion following arthroscopic lysis of adhesions for noninfectious stiffness after shoulder arthroplasty. Methods: A systematic review was conducted using five databases. The reason for shoulder arthroplasty, type of arthroplasty, time from arthroplasty to arthroscopy, follow-up duration, preoperative and postoperative range of motion, patient-reported outcomes, complications, reintervention or revision, and patient satisfaction were collected. No pooled estimates were calculated due to the heterogeneity of study designs, small sample sizes, and the moderate-to-low methodological quality of the included studies. Results: Four studies, which amounted to 29 patients, published from 2000 to 2024 were included. Preoperative ranges were 20°–120° for forward flexion, 20°–60° for abduction, 0°–60° for external rotation, and hip to L2 for internal rotation. Postoperatively, these improved to 60°–170°, 51°–110°, 0°–80°, and hip to T9, respectively. No complications or reintervention were reported. Patient satisfaction rates ranged from 74% to 100%. Follow-up ranged from 12 to 55 months. Discussion: Arthroscopic lysis of adhesions appears to be a safe and effective treatment for stiffness following shoulder arthroplasty.