Frozen shoulder

Abstract

Frozen shoulder is commonly encountered in general orthopaedic practice. It may arise spontaneously without an obvious predisposing cause, or be associated with a variety of local or systemic disorders. Diagnosis is based upon the recognition of the characteristic features of the pain, and selective limitation of passive external rotation. The macroscopic and histological features of the capsular contracture are well-defined, but the underlying pathological processes remain poorly understood. It may cause protracted disability, and imposes a considerable burden on health service resources. Most patients are still managed by physiotherapy in primary care, and only the more refractory cases are referred for specialist intervention. Targeted therapy is not possible and treatment remains predominantly symptomatic. However, over the last ten years, more active interventions that may shorten the clinical course, such as capsular distension arthrography and arthroscopic capsular release, have become more popular. This review describes the clinical and pathological features of frozen shoulder. We also outline the current treatment options, review the published results and present our own treatment algorithm.

The management of secondary frozen shoulder after anterior shoulder dislocation – The results of manipulation under anaesthesia and injection

“…11 The pathology of secondary frozen shoulder remains poorly understood but there may be additional rotator cuff and soft tissue contracture leading to a poorer prognosis. 1 All three patients had good initial improvement in OSS and ROM at their initial follow-up. In our experience with primary frozen shoulder, those patients with improvement in OSS and ROM at initial follow-up usually represents a successful primary procedure.…”

“…Those cases of frozen shoulder with an identifiable non-traumatic (OA, rotator cuff tendinopathy, calcific tendinitis) or traumatic (fracture, dislocation, soft tissue injury) shoulder pathology are categorised as having secondary frozen shoulder. 1 Shoulder dislocations affect approximately 1.7% of the population and are most frequently secondary to trauma, with over 95% being anterior dislocations. 2 It is known that there is a bimodal age and sex distribution with peak incidence in men aged 20-30 years and in women aged 61-80 years.…”

“…It may therefore be more recalcitrant to conservative treatment and more likely to require intervention as the chance of spontaneous resolution is less for these types of frozen shoulder. 1 To our knowledge, no studies to date have documented the natural history of patients with secondary frozen shoulder from a previous shoulder dislocation. We were faced with a group of patients who had developed secondary frozen shoulder following an anterior shoulder dislocation and failed conservative treatment by physiotherapy.…”

Letter to the Editor: Effectiveness of Sustained Stretching of the Inferior Capsule in the Management of a Frozen Shoulder

“…No amount of restriction was defined, and also, no direction of the limitations was reported. The characteristic pattern of limitation of both active and passive loss of external rotation [7] was not a criterion in this study. The duration of symptoms was not reported in the inclusion and exclusion criteria.…”

Evaluation of the Clinical Practice of Shoulder Examination among Ten Experienced Shoulder Surgeons

“…For frozen shoulder the test is considered positive if the passive range of motion is decreased [13][14][15][16].…”