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[In Process Citation]

Hertel1

  • 1Universitatsklinik fur Orthopadische Chirurgie,|| Inselspital, CH-3010 Bern. ralph.hertel@insel.ch

Der Orthopade
|December 16, 2000
PubMed
Summary

Frozen shoulder, a painful shoulder stiffness, involves joint capsule inflammation and scarring. Treatment requires careful timing, avoiding aggressive methods during inflammation, with potential benefits from anti-angiogenetic agents.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Sports Medicine

Background:

  • Frozen shoulder, also known as adhesive capsulitis, is a complex shoulder condition with varied terminology.
  • It can arise idiopathically or secondary to trauma, infection, tumors, radiation, or metabolic issues.
  • Pathologically, it involves inflammatory vascular proliferation leading to joint capsule thickening, scarring, and retraction.

Purpose of the Study:

  • To provide a comprehensive overview of frozen shoulder, encompassing its definition, etiology, pathology, diagnosis, and treatment.
  • To highlight the importance of appropriate treatment timing and modality selection.
  • To explore novel therapeutic approaches, such as anti-angiogenetic agents.

Main Methods:

  • Clinical diagnosis relies on patient history and physical examination.
  • Understanding the natural progression of the disease, from initial pain to restricted range of motion.
  • Review of current and potential treatment strategies, including mobilization, injections, distension, manipulation, and surgical arthrolysis.

Main Results:

  • Pain, particularly nocturnal pain, typically precedes the noticeable decrease in shoulder range of motion.
  • The condition progresses through stages, with inflammation in early phases and stiffness dominating later.
  • Various treatment options exist, but their effectiveness depends on the stage of the disease and timely intervention.

Conclusions:

  • Accurate diagnosis and staging are crucial for effective frozen shoulder management.
  • Aggressive treatments may be contraindicated during the inflammatory phase.
  • Emerging therapies like anti-angiogenetic agents show promise for improving outcomes and shortening recovery time.

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