Sint-Maarten Ziekenhuis, Mechelen, Belgium.
Royal College of Surgeons in Ireland, Dublin, Ireland.
J Shoulder Elbow Surg. 2022 Aug;31(8):1682-1686. doi: 10.1016/j.jse.2022.01.123. Epub 2022 Feb 12.
Although there is evidence that the COVID-19 pandemic had profound physiological and psychological effects, there is no research aimed at understanding if the pandemic has had an impact on the incidence or severity of frozen shoulder (FS). The aim of this study was to compare the incidence and severity of idiopathic FS before and during the pandemic.
A retrospective cohort study was performed to establish the incidence of FS during the pandemic, from March 2020 to January 2021 (pandemic study period), compared to the same time period 1 year earlier, before the pandemic (control group). All patients who were diagnosed with idiopathic FS were included. To assess the severity of the condition, visual analog scale (VAS) for pain score and Subjective Shoulder Value (SSV) on presentation were recorded and the patients were categorized into 5 different treatment groups (0 injections, 1 injection, 2 injections, 3 injections, or capsular release). As the pandemic and public health restrictions could have influenced the availability of appointments, the waiting time between referral and first appointment was calculated as a possible confounding factor. Statistical analysis was performed using the chi-square and Student t test for categorical and continuous variables, respectively.
There were 847 new patient consultations during the pandemic study period; of these, 232 were for idiopathic FS. One year earlier, there were 898 initial consultations for a new shoulder problem; of these, 176 were for idiopathic FS. This represents a relative increase of 39.8% (P < .001) in the incidence of patients with FS. The mean SSV in the control group was 50% ± 20% vs. 45% ± 18% in the pandemic group-statistically significant (P = .013) but unlikely to be clinically significant. The VAS pain score was similar in both groups: mean 6 ± 2 and 7 ± 2, respectively (P = .06). There was no significant difference between the control and the pandemic group in the distribution of patients per treatment group (P = .94). The mean waiting time from referral to appointment was not significantly different between the control and the pandemic group: 58 ± 30 days vs. 55 ± 27 days (P = .30).
During the COVID-19 pandemic, there was a significant increase in the incidence of patients with FS. No significant difference in severity was observed. Further research is needed to evaluate a causal relationship between the COVID-19 pandemic and FS.
尽管有证据表明 COVID-19 大流行对人们的生理和心理都产生了深远的影响，但目前尚无研究旨在了解大流行是否会影响冻结肩（FS）的发病率或严重程度。本研究旨在比较大流行前后特发性 FS 的发病率和严重程度。
本回顾性队列研究旨在确定 2020 年 3 月至 2021 年 1 月（大流行研究期间）期间特发性 FS 的发病率，并与大流行前（对照组）的同一时间段（1 年前）进行比较。所有被诊断为特发性 FS 的患者均被纳入研究。为了评估病情的严重程度，记录了就诊时的视觉模拟评分（VAS）疼痛评分和主观肩部值（SSV），并将患者分为 5 种不同的治疗组（0 次注射、1 次注射、2 次注射、3 次注射或囊松解）。由于大流行和公共卫生限制可能会影响预约的可及性，因此计算了从转诊到首次就诊的等待时间，作为可能的混杂因素。分别使用卡方检验和学生 t 检验对分类变量和连续变量进行统计分析。
大流行研究期间有 847 名新患者就诊；其中 232 名患有特发性 FS。一年前，有 898 名新出现肩部问题的患者首次就诊；其中 176 名患有特发性 FS。这表明 FS 患者的发病率相对增加了 39.8%（P<0.001）。对照组的平均 SSV 为 50%±20%，大流行组为 45%±18%，统计学上有显著差异（P=0.013），但可能无临床意义。两组的 VAS 疼痛评分相似：分别为 6±2 和 7±2（P=0.06）。控制组和大流行组之间的治疗组患者分布无显著差异（P=0.94）。从转诊到预约的平均等待时间在对照组和大流行组之间无显著差异：58±30 天和 55±27 天（P=0.30）。
在 COVID-19 大流行期间，FS 患者的发病率显著增加。未观察到严重程度的显著差异。需要进一步研究以评估 COVID-19 大流行与 FS 之间的因果关系。
