Huang Pao, Hong Ching-I, Liang Chung-Chao, Wu Wen-Tien, Wang Jen-Hung, Yeh Kuang-Ting
Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.
Department of Special Education, National Dong Hwa University, Hualien 974, Taiwan.
Healthcare (Basel). 2023 Jun 15;11(12):1758. doi: 10.3390/healthcare11121758.
This study investigated the association of de Quervain tenosynovitis (DQT) with subsequent adhesive capsulitis (AC) development. Patients with DQT between 2001 and 2017 from the Taiwan National Health Insurance Research Database were the DQT cohort. The 1:1 propensity score matching method was applied for creating control cohort. The primary outcome was defined as new-onset of AC at least 1 year after the date of confirmed diagnosis of DQT. In total, 32,048 patients with mean age 45.3 years were included. DQT was significantly positively associated with risk of new-onset AC after adjustment for baseline characteristics. Furthermore, severe DQT requiring rehabilitation was positively associated with risk of new-onset AC. In addition, male gender and age under 40 may be additional risk factors for new-onset AC, compared to female gender and age over 40. Cumulative incidence of AC after 17 years was 24.1% among patients with severe DQT requiring rehabilitation and was 20.8% among patients with DQT without rehabilitation. This is the first population-based study to demonstrate an association between DQT and new-onset AC. The findings recommend that preventive occupational therapy, including active modification for the shoulder joint and adjustments to daily activities, may be necessary for patients with DQT to reduce their risk of developing AC.
本研究调查了桡骨茎突狭窄性腱鞘炎(DQT)与随后发生的粘连性关节囊炎(AC)之间的关联。来自台湾国民健康保险研究数据库的2001年至2017年间患有DQT的患者作为DQT队列。采用1:1倾向评分匹配法创建对照队列。主要结局定义为在确诊DQT日期至少1年后新发AC。总共纳入了32048例平均年龄为45.3岁的患者。在对基线特征进行调整后,DQT与新发AC的风险显著正相关。此外,需要康复治疗的严重DQT与新发AC的风险正相关。此外,与女性和40岁以上人群相比,男性和40岁以下人群可能是新发AC的额外危险因素。在需要康复治疗的严重DQT患者中,17年后AC的累积发病率为24.1%,在未进行康复治疗的DQT患者中为20.8%。这是第一项基于人群的研究,证明了DQT与新发AC之间的关联。研究结果表明,对于DQT患者,可能需要进行预防性职业治疗,包括对肩关节进行主动调整和对日常活动进行调整,以降低其发生AC的风险。