Franz A, Klose M, Beitzel K
ATOS Orthoparc Klinik, Aachener Str. 1021B, 50858, Köln, Deutschland.
Abteilung für Sportorthopädie, Technische Universität München, München, Deutschland.
Unfallchirurg. 2019 Dec;122(12):934-940. doi: 10.1007/s00113-019-00731-3.
Idiopathic shoulder stiffness (i.e. frozen shoulder, FS) is a common pathology of the glenohumeral joint characterized by a sudden onset of pain syndrome and progressive restriction of the range of motion. While the histological changes of FS are accompanied by synovial inflammation and increasing capsular fibrosis, the underlying cause of FS is still unknown. The treatment options for FS are multifarious and include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic and open capsular release. As the disease is usually self-limiting and the symptoms resolve after 2-3 years, especially conservative treatment measures are often clinically applied; however, in this context there is still no scientifically based consensus on which treatment measures are most likely to contribute to symptom relief in which phase of the disease. For this reason, this article focuses on the description of the scientifically investigated conservative treatment methods in FS and their temporal classification into the classical three-phase course of the disease.
特发性肩关节僵硬(即肩周炎,FS)是一种常见的盂肱关节疾病,其特征为突然发作的疼痛综合征和活动范围的进行性受限。虽然肩周炎的组织学变化伴有滑膜炎症和关节囊纤维化加重,但其根本原因仍不清楚。肩周炎的治疗选择多种多样,包括药物治疗、局部类固醇注射、物理治疗、关节镜下扩张、麻醉下手法松解、关节镜下和开放性关节囊松解。由于该病通常为自限性,症状在2 - 3年后会缓解,因此临床上常采用保守治疗措施;然而,在这种情况下,对于哪种治疗措施最有可能在疾病的哪个阶段缓解症状,仍没有基于科学的共识。因此,本文重点描述肩周炎中经科学研究的保守治疗方法及其在疾病经典的三个阶段过程中的时间分类。