Kim Du Hwan, Kim Young Soo, Kim Beom-Soo, Sung Duk Hyun, Song Kwang-Soon, Cho Chul-Hyun
Department of Rehabilitation Medicine, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
Department of Orthopedic Surgery, Keunmadi Hospital, Kyungju, South Korea.
J Orthop Sci. 2020 Mar;25(2):224-228. doi: 10.1016/j.jos.2019.03.011. Epub 2019 Apr 2.
Although numerous studies have suggested that frozen shoulder (FS) is a self-limiting disease with most patients recovering within 2 years, its long-term outcome is still controversial. The aims of this study were to evaluate the clinical outcomes after conservative treatment for FS and to determine the predictors of its clinical outcome.
This study included 234 shoulders of 215 patients who received conservative treatment for FS. The mean follow-up period was 41.8 months (range 27-117 months). Initial evaluation included demographics, detailed medical history, and clinical assessments of shoulder status. Questionnaires, which included the Visual Analogue Scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV) and satisfaction grading for the current shoulder status were assessed at the final follow-up.
The mean VAS pain score, ASES score, and SSV significantly improved from 6.7, 37.0, and 40.1% at the time of initial evaluation to 1.5, 87.6, and 85.0% at the final follow-up evaluation (all p < 0.001). According to satisfaction grading, the shoulder status at the final follow-up was very satisfied in 101 shoulders (43.2%), satisfied in 68 (29.1%), fair in 37 (15.8%), unsatisfied in 20 (8.5%), and very unsatisfied in 8 (3.4%). Univariate analysis revealed that gender, diabetes, simultaneous bilateral involvement, overall bilateral involvement and duration of symptoms were associated with clinical outcomes at the final follow-up. Multivariate analysis revealed that duration of symptoms (p = 0.002) was an independent risk factor for unsuccessful outcome.
At the mean follow-up period of 41.8 months, 72.3% of patients revealed subjective satisfaction for the current shoulder status. Duration of symptoms was an independent risk factor for poor prognosis.
尽管众多研究表明肩周炎（FS）是一种自限性疾病，大多数患者在2年内康复，但其长期预后仍存在争议。本研究的目的是评估FS保守治疗后的临床疗效，并确定其临床疗效的预测因素。
本研究纳入了215例接受FS保守治疗患者的234个肩部。平均随访期为41.8个月（范围27 - 117个月）。初始评估包括人口统计学、详细病史以及肩部状况的临床评估。在最终随访时评估问卷，其中包括视觉模拟量表（VAS）疼痛评分、美国肩肘外科医师（ASES）评分、主观肩部价值（SSV）以及对当前肩部状况的满意度分级。
平均VAS疼痛评分、ASES评分和SSV从初始评估时的6.7、37.0和40.1%显著改善至最终随访评估时的1.5、87.6和85.0%（所有p < 0.001）。根据满意度分级，最终随访时肩部状况非常满意的有101个（43.2%），满意的有68个（29.1%），一般的有37个（15.8%），不满意的有20个（8.5%），非常不满意的有8个（3.4%）。单因素分析显示，性别、糖尿病、双侧同时受累、总体双侧受累以及症状持续时间与最终随访时的临床疗效相关。多因素分析显示，症状持续时间（p = 0.002）是治疗效果不佳的独立危险因素。
在平均41.8个月的随访期内，72.3%的患者对当前肩部状况表示主观满意。症状持续时间是预后不良的独立危险因素。
