Liu Xu, Yang Guang, Xie Wenqing, Lu Wenhao, Liu Gaoming, Xiao Wenfeng, Li Yusheng
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Asian J Surg. 2024 Nov 11. doi: 10.1016/j.asjsur.2024.10.148.
Frozen shoulder (FS), characterized by pain and restricted mobility, remains a challenging condition with unclear optimal treatment. This study aims to investigate the development of FS research, identify hotspot treatments, and verify their efficacy. Analyzing 3139 FS-related publications from the Web of Science Core Collection revealed a significant rise in publications (R = 0.9478), with the United States as a leader in this research area. Our keyword analysis pinpointed suprascapular nerve block (SSNB) as a notable research focus since 2021. To assess the effectiveness of SSNB, we conducted a meta-analysis of eight randomized controlled trials including 435 patients. The results at the 6-8 weeks follow-up showed SSNB significantly reduced pain and improved active shoulder function compared to intra-articular corticosteroid injections (IACI). Specifically, SSNB led to considerable enhancements in abduction (SMD: 12.88; 95 % CI: 4.13, 21.64; p = 0.004; I = 54 %), flexion (SMD: 9.16; 95 % CI: 6.50, 11.82; p < 0.00001; I = 0 %), and external rotation (SMD: 18.03; 95 % CI: 6.59, 29.48; p = 0.008; I = 59 %). Additionally, there was a significant reduction in Shoulder Pain and Disability Index (SPADI) scores (SMD: 4.46; 95 % CIs: 7.75, -1.17; p = 0.008; I = 59 %). Despite these findings, no differences were observed in the improvement of passive activities between the SSNB and IACI groups at any follow-up. This study supports the short-term benefits of SSNB for FS, prompting further investigation into its long-term efficacy and comparison with other treatments.
冻结肩（FS）以疼痛和活动受限为特征，仍然是一种具有挑战性的病症，最佳治疗方法尚不清楚。本研究旨在调查冻结肩研究的发展情况，确定热点治疗方法，并验证其疗效。对来自科学网核心合集的3139篇与冻结肩相关的出版物进行分析后发现，出版物数量显著增加（R = 0.9478），美国是该研究领域的领先者。我们的关键词分析指出，自2021年以来，肩胛上神经阻滞（SSNB）是一个值得注意的研究重点。为了评估肩胛上神经阻滞的有效性，我们对八项随机对照试验进行了荟萃分析，共纳入435例患者。6-8周随访结果显示，与关节内注射皮质类固醇（IACI）相比，肩胛上神经阻滞显著减轻了疼痛，并改善了肩部主动功能。具体而言，肩胛上神经阻滞在外展（标准化均数差：12.88；95%置信区间：4.13，21.64；p = 0.004；I² = 54%）、屈曲（标准化均数差：9.16；95%置信区间：6.50，11.82；p < 0.00001；I² = 0%）和外旋（标准化均数差：18.03；95%置信区间：6.59，29.48；p = 0.008；I² = 59%）方面有显著改善。此外，肩部疼痛和功能障碍指数（SPADI）评分显著降低（标准化均数差：4.46；95%置信区间：7.75，-1.17；p = 0.008；I² = 59%）。尽管有这些发现，但在任何随访中，肩胛上神经阻滞组和关节内注射皮质类固醇组在被动活动改善方面均未观察到差异。本研究支持肩胛上神经阻滞对冻结肩的短期益处，促使对其长期疗效进行进一步研究，并与其他治疗方法进行比较。
