What is Capsulotomy?

Capsulotomy is a surgical procedure that involves cutting or releasing part of the joint capsule—the thick fibrous tissue that surrounds a joint. This is done to improve range of motion and relieve joint stiffness, especially when non-surgical treatments fail to restore mobility.

At Katranji Hand Center, capsulotomy is most often performed in the fingers, wrist, or elbow, particularly following trauma, surgery, or conditions that result in joint contracture or scarring.

Causes

Capsulotomy may be recommended for:

• Post-traumatic joint stiffness (e.g., after a fracture or dislocation)

• Arthrofibrosis – excessive scar tissue limiting joint movement

• Failed conservative treatment for joint contractures

• Chronic inflammatory conditions like rheumatoid arthritis

• Post-surgical adhesions that restrict motion

Signs & Symptoms

Indications for capsulotomy include:

• Inability to fully bend or straighten a joint

• Painful or restricted motion

• Joint tightness that persists after therapy

• Functional limitations in daily tasks (gripping, writing, lifting)

• Deformity or “frozen” joint appearance

Diagnosis

At Katranji Hand Center, evaluation includes:

• Detailed clinical examination – to measure active and passive range of motion

• X-rays – to rule out bony abnormalities or joint damage

• MRI or ultrasound – in certain cases to assess soft tissue scarring or capsular thickening

• Functional assessments – to determine impact on daily living and occupational function

Treatment Options

Non-Surgical

• Physical and occupational therapy

• Splinting and dynamic bracing

• Steroid injections

• Serial casting

• If these fail to restore adequate movement, surgery may be indicated.

Surgical Capsulotomy

• Performed under regional or general anesthesia

• A small incision is made to access the stiff joint

• The joint capsule is partially or completely released to restore motion

• In some cases, adjacent scar tissue, adhesions, or contracted ligaments are also removed

• May be combined with tenolysis or osteotomy if additional restrictions are present

This is often done as an outpatient procedure with early mobilization protocols.

Postoperative Care

• Early motion is key – therapy often begins within 1–3 days

• Custom splinting to maintain gains in motion

• Pain management to allow full participation in rehab

• Full recovery can take 6 to 12 weeks, with improvements continuing for several months

Associated Risks

While generally safe, capsulotomy carries potential risks such as:

• Infection

• Scar tissue reformation

• Nerve or vessel injury

• Incomplete restoration of motion

• Joint instability (if over-released)

Prognosis

When performed at the right time and followed by structured therapy, capsulotomy can significantly improve joint mobility and hand function. At Katranji Hand Center, we specialize in motion-restoring procedures and post-op rehab protocols that help patients return to full use of their hands and upper extremities.