Stiffness following shoulder arthroplasty: To manipulate or not

Shoulder arthroplasty is considered the gold standard for treatment of end stage glenohumeral arthritis in select patients. This procedure routinely achieves excellent clinical outcomes for most patients, and fortunately complications are rare. Post-surgical stiffness is one such complication, which can be difficult to appropriately manage clinically. Causes include a preoperative diagnosis of proximal humerus fracture, infection, inadequate postoperative rehabilitation, and implant-related factors such as malpositioning. When nonoperative modalities such as physical therapy and corticosteroid injections fail, surgical options include glenohumeral debridement, subacromial decompression, and capsular release with or without manipulation.