• Jun Xu, Xiaodong Chen, De Li, Hanlong Xin, Wei Wang, Yue Wang, and Jianhua Wang.
• Department of Orthopaedic Surgery, Wuhan Central Hospital, Huazhong University of Science and Technology, Wuhan, China.
• Arch Orthop Trauma Surg. 2013 Nov 1;133(11):1549-56.

BackgroundIn recent two decades, a novel minimally invasive technique for resistant frozen shoulder, arthroscopic glenohumeral release, has been popularly practiced. However, by far one key point, although being well recognized, has not been tackled at all during the procedure-that is how to safely and smoothly insert the arthroscope into contracted and restricted glenohumeral joint when MUA cannot be performed or work, especially the severe stiff shoulder.Materials And MethodsWe have developed a new strategy for the treatment of the problem-initial glenohumeral visualization through musculotendinous junction of supraspinatus. Using this accessory portal, the posterior glenohumeral joint could be viewed and an accurate posterior portal was instituted through which the arthroscope could be placed into glenohumeral joint definitely parallel to the glenoid face without injuring the articular cartilage; the arthroscope and electrocautery could move more freely to favor subsequent sequential glenohumeral release as well. In this report we present this technique in detail and intraoperative results in 27 consecutive severe frozen shoulders.ResultsThe success rate of initial glenohumeral placement of arthroscope through trans-cuff portal was 100 % without glenoid or humeral head cartilage injury.ConclusionsFor severe frozen shoulder, initial glenohumeral visualization through trans-cuff portal is practical, safe and reproducible.Level Of EvidenceLevel IV, Case Series, Treatment Study.

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