粘连性肩关节囊炎及微创治疗选择的全面更新。
A Comprehensive Update of Adhesive Capsulitis and Minimally Invasive Treatment Options.
机构信息
Patel, MD, Wolf, BS, Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ. Urits, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA. Murthy, MS, BS, Georgetown University School of Medicine, Washington, D.C. Cornett, PhD, Louisiana State University Health Sciences Center, Department of Anesthesiology, New Orleans, LA. Ngo, MD, MBA, Pain Specialty Group, Department of Pain Medicine, Newington, NH; Harvard Medical School, Boston, MA. Manchikanti, MD, Pain Management Centers of America, Paducah, KY. Kaye, Departments of Anesthesiology and Pharmacology, Toxicology and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA. Viswanath, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE.
出版信息
Psychopharmacol Bull. 2020 Oct 15;50(4 Suppl 1):91-107.
BACKGROUND
Adhesive capsulitis of the shoulder (AC) is characterized by fibrosis and contracture of the glenohumeral joint capsule, resulting in progressive stiffness, pain, and restriction of motion of the shoulder. The prevalence of AC is estimated to be 2-5% of the general population. Patients with AC typically have an insidious onset of pain and can progress to severe limitation of the shoulder leading to significant disability and decreased quality of life.
OBJECTIVES
The objective of this manuscript is to provide a comprehensive review of AC with a focus on clinical presentation, natural history, pathophysiology, and various treatment modalities.
STUDY DESIGN
A review article.
SETTING
A review of literature.
METHODS
A search was made on the Pubmed database using the keywords of adhesive capsulitis, frozen shoulder, shoulder capsulitis, arthrofibrosis, shoulder pain, shoulder stiffness.
RESULTS
Our search identified numerous studies in order to provide a comprehensive review of the current understanding of the treatment and management of AC.
LIMITATIONS
There remains limited evidence in literature about the understanding of AC and optimal treatment.
CONCLUSION
AC is an important cause of chronic pain and disability. There is currently no consensus on treatment. Initial treatment modalities revolve around conservative measures as well as aggressive physical therapy. Further treatment options include intraarticular injections, hydro-dilation, nerve blocks, and for more refractory cases, surgical interventions such as arthroscopic capsulotomy.
背景
肩粘连性关节囊炎（AC）的特征为盂肱关节囊纤维化和挛缩，导致肩部进行性僵硬、疼痛和运动受限。AC 的患病率估计为普通人群的 2-5%。AC 患者通常疼痛隐匿发作，并可进展为严重的肩部受限，导致显著残疾和生活质量下降。
目的
本文旨在全面综述 AC，重点介绍其临床表现、自然病程、病理生理学和各种治疗方法。
研究设计
综述文章。
设置
文献复习。
方法
在 Pubmed 数据库中使用粘连性关节囊炎、冻结肩、肩袖炎、关节纤维变性、肩部疼痛、肩部僵硬等关键词进行检索。
结果
我们的检索确定了许多研究，以便全面综述目前对 AC 的治疗和管理的理解。
局限性
关于 AC 的理解和最佳治疗方法，文献中仍存在有限的证据。
结论
AC 是慢性疼痛和残疾的重要原因。目前尚无治疗共识。初始治疗方法主要围绕保守治疗以及积极的物理治疗。进一步的治疗选择包括关节内注射、液压扩张、神经阻滞，对于更难治的病例，手术干预如关节镜下囊切开术。
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