Cho Chul-Hyun, Kim Dong-Hu, Lee Young-Kuk
Pain Research Center, Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Republic of Korea.
Department of Orthopedic Surgery, The Open Hospital, Daegu, Republic of Korea.
Arthroscopy. 2016 Aug;32(8):1515-20. doi: 10.1016/j.arthro.2016.01.040. Epub 2016 Apr 6.
To compare serial clinical outcomes after arthroscopic treatment of refractory frozen shoulder with and without diabetes.
Seventeen patients with diabetic frozen shoulder (diabetes group) and 20 patients with idiopathic frozen shoulder (idiopathic group) were included. The mean follow-up period was 48.4 ± 15.8 months. Visual analog scale pain score; University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; and range of motion were evaluated preoperatively; at 3, 6, and 12 months after surgery; and at the final follow-up examination.
Both groups showed significant improvement in all clinical scores and range of motion during the serial follow-up periods (P < .001). There were no significant differences between the 2 groups in any of the assessed clinical scores, except the mean American Shoulder and Elbow Surgeons score in the diabetes group was significantly lower than that in the idiopathic group at 12 months after surgery (77.7 v 88.8, P = .025). In the diabetes group, mean forward flexion was significantly lower than that in the idiopathic group at 3 months (140.0° v 151.5°, P = .011) and 6 months (152.2° v 161.8°, P = .045) after surgery. Mean external rotation was significantly lower than that in the idiopathic group at 6 months after surgery (43.3° v 55.0°, P = .021). Mean internal rotation was significantly lower than that in the idiopathic group at 6 months (13.7 v 11.7, P = .006) and 12 months (12.2 v 9.9, P = .041) after surgery. There were no significant differences between the 2 groups in any assessed outcomes at the final follow-up examination.
These results provide supportive evidence suggesting that the diabetes group had slower postoperative functional recovery until 12 months postoperatively, although arthroscopic capsular release for refractory frozen shoulder with and without diabetes yielded satisfactory clinical outcomes at the final follow-up examination.
Level III, retrospective comparative study.
比较关节镜治疗难治性肩周炎伴糖尿病和不伴糖尿病患者的系列临床疗效。
纳入17例糖尿病性肩周炎患者（糖尿病组）和20例特发性肩周炎患者（特发性组）。平均随访时间为48.4±15.8个月。术前、术后3个月、6个月、12个月及末次随访时评估视觉模拟评分法疼痛评分、加州大学洛杉矶分校评分、美国肩肘外科医师学会评分及活动范围。
两组在系列随访期间所有临床评分和活动范围均有显著改善（P<.001）。两组在任何评估的临床评分上均无显著差异，但糖尿病组术后12个月的平均美国肩肘外科医师学会评分显著低于特发性组（77.7对88.8，P=.025）。糖尿病组术后3个月（140.0°对151.5°，P=.011）和6个月（152.2°对161.8°，P=.045）的平均前屈显著低于特发性组。术后6个月糖尿病组平均外旋显著低于特发性组（43.3°对55.0°，P=.021）。术后6个月（13.7对11.7，P=.006）和12个月（12.2对9.9，P=.041）糖尿病组平均内旋显著低于特发性组。末次随访时两组在任何评估结果上均无显著差异。
这些结果提供了支持性证据，表明糖尿病组术后功能恢复较慢，直至术后12个月，尽管关节镜下关节囊松解术治疗难治性肩周炎伴糖尿病和不伴糖尿病患者在末次随访时均取得了满意的临床疗效。
III级，回顾性比较研究。
