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“冻结肩”的定义并不明确。怎样能更好地描述它呢?

'Frozen shoulder' is ill-defined. How can it be described better?

作者信息

Abrassart Sophie, Kolo Franck, Piotton Sébastian, Chih-Hao Chiu Joe, Stirling Patrick, Hoffmeyer Pierre, Lädermann Alexandre

机构信息

Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.

Rive Droite Radiology Centre, Geneva, Switzerland.

出版信息

EFORT Open Rev. 2020 May 1;5(5):273-279. doi: 10.1302/2058-5241.5.190032. eCollection 2020 May.

Abstract

Frozen shoulder, a common and debilitating shoulder complaint, has been the subject of uncertainty within the scientific literature and clinical practice.We performed an electronic PubMed search on all (1559) articles mentioning 'frozen shoulder' or 'adhesive capsulitis' to understand and qualify the range of naming, classification and natural history of the disease. We identified and reviewed six key thought leadership papers published in the past 10 years and all (24) systematic reviews published on frozen shoulder or adhesive capsulitis in the past five years.This revealed that, while key thought leaders such as the ISAKOS Upper Extremity Council are unequivocal that 'adhesive capsulitis' is an inappropriate term, the long-term and short-term trends showed the literature (63% of systematic reviews assessed) preferred 'adhesive capsulitis'.The literature was divided as to whether or not to classify the complaint as (9 of 24) or (9 of 24); six did not touch on classification.Furthermore, despite a systematic review in 2016 showing no evidence to support a three-phase self-limiting progression of frozen shoulder, 11 of 12 (92%) systematic reviews that mentioned phasing described a three-phase progression. Eight (33%) described it as 'self-limiting', three (13%) described it as self-limiting in 'nearly all' or 'most' cases, and six (25%) stated that it was not self-limiting; seven (29%) did not touch on disease resolution.We call for a data and patient-oriented approach to the classification and description of the natural history of the disease, and recommend authors and clinicians (1) use the term 'frozen shoulder' over 'adhesive capsulitis', (2) use an updated definition of the disease which recognizes the often severe pain suffered, and (3) avoid the confusing and potentially harmful repetition of the natural history of the disease as a three-phase, self-limiting condition. Cite this article: 2020;5:273-279.DOI: 10.1302/2058-5241.5.190032.

摘要

肩周炎是一种常见且使人衰弱的肩部疾病,在科学文献和临床实践中一直存在不确定性。我们在电子数据库PubMed中搜索了所有提及“肩周炎”或“粘连性关节囊炎”的文章(共1559篇),以了解并界定该疾病的命名范围、分类及自然病程。我们找出并回顾了过去10年发表的6篇关键的思想领袖论文以及过去5年发表的所有关于肩周炎或粘连性关节囊炎的系统评价(共24篇)。结果显示,虽然国际关节镜、膝关节外科和骨科运动医学学会(ISAKOS)上肢委员会等关键思想领袖明确认为“粘连性关节囊炎”是一个不恰当的术语,但长期和短期趋势表明,文献(63%的系统评价)更倾向于使用“粘连性关节囊炎”。对于是否将该疾病归类为[具体分类1](24篇中有9篇)或[具体分类2](24篇中有9篇),文献存在分歧;6篇未涉及分类问题。此外,尽管2016年的一项系统评价显示没有证据支持肩周炎存在三阶段自限性病程,但在提及分期的12篇系统评价中,有11篇(92%)描述了三阶段病程。8篇(33%)将其描述为“自限性”,3篇(13%)描述为在“几乎所有”或“大多数”病例中自限,6篇(25%)表示它不是自限性的;7篇(29%)未涉及疾病转归问题。我们呼吁采用以数据和患者为导向的方法来对该疾病的自然病程进行分类和描述,并建议作者和临床医生:(1)使用“肩周炎”而非“粘连性关节囊炎”这一术语;(2)采用该疾病的最新定义,该定义应认识到患者常遭受的剧痛;(3)避免将该疾病的自然病程混乱且可能有害地重复描述为三阶段自限性疾病。引用本文:[具体引用格式] 2020;5:273 - 279。DOI:10.1302/2058 - 5241.5.190032。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f48f/7265085/a9e475c619fa/eor-5-273-g001.jpg

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