Adhesive capsulitis of the shoulder.

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Abstract

[Indexed for MEDLINE] 2. Arthroscopy. 2016 Jul;32(7):1402-14. doi: 10.1016/j.arthro.2016.03.024. Epub 2016 May 12. Shoulder Stiffness: Current Concepts and Concerns. Itoi E(1), Arce G(2), Bain GI(3), Diercks RL(4), Guttmann D(5), Imhoff AB(6), Mazzocca AD(7), Sugaya H(8), Yoo YS(9). Author information: (1)Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan. Electronic address: itoi-eiji@med.tohoku.ac.jp. (2)Department of Orthopaedic Surgery, Instituto Argentino de Diagnóstico y Tratamiento, Buenos Aires, Argentina. (3)Department of Orthopedic Surgery, Flinders University, Adelaide, South Australia, Australia. (4)Sports Medicine Center, Department of Orthopaedic Surgery, University of Groningen, Groningen, the Netherlands. (5)Taos Orthopaedic Institute, Shoulder and Elbow Service, Taos, New Mexico, U.S.A. (6)Department of Orthopaedic Sports Medicine, University of Munich (TUM), Hospital Rechts der Isar, Munich, Germany. (7)Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, Farmington, Connecticut, U.S.A. (8)Shoulder & Elbow Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan. (9)Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Gyeonggi-Do, Republic of Korea. Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be used to describe shoulder stiffness with a known cause. The pathophysiology of frozen shoulder is capsular fibrosis and inflammation with chondrogenesis, but the cause is still unknown. Conservative treatment is the primary choice. Pain control by oral medication, intra-articular injections with or without joint distension, and physical therapy are commonly used. In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. After the capsular release, stepwise rehabilitation is mandatory to achieve satisfactory outcome. LEVEL OF EVIDENCE: Level V, evidence-based review. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.arthro.2016.03.024