We expose the origin of the triceps from the infraglenoid tubercle with this release. We insert a humeral head retractor into the joint and twist it slightly to tension the posterior inferior capsule so that it can be safely sectioned. By twisting the retractor a little more with each bit of posterior capsular release, we can safely release the posterior capsule up to the origin of biceps tendon at the supraglenoid tubercle. The lengthened subscapularis tendon is then sutured to the capsule attached to the lesser tuberosity. As soon as the procedure is completed, we place the arm in continuous passive motion .
Early motion achieves several goals.
It prevents formation of adhesions or scarring during the critical early healing period. It also demonstrates to the patient that the shoulder can and should be moved immediately. Finally, early movement seems to increase the comfort, speed, and completeness of motion recovery. The use of the continuous passive motion after surgery is greatly facilitated by a brachial plexus block for the surgical procedure. On the first day after surgery, the patient resumes the stiff shoulder exercises .