Rupani Neal, Gwilym Steve E
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Shoulder Elbow. 2025 Apr 23:17585732251335955. doi: 10.1177/17585732251335955.
Current guidelines from the British Elbow and Shoulder Society (BESS) were published in 2015 for managing frozen shoulders in the primary and secondary care setting. Updated guidelines have been developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology.
A multi-disciplinary BESS Working Group defined key management questions based on agreed outcome measures and time points. A literature search, conducted up to March 2023 following PRISMA guidelines, identified randomised controlled trials, systematic reviews, and meta-analyses. Quality assessments were performed using the GRADE Decision Framework, considering bias, imprecision, indirectness, and inconsistency. Data were extracted for meta-analysis. In the absence of high-quality trials, narrative reviews were created.
Consensus opinions produced statements based on the quality and volume of evidence and the magnitude of desirable and undesirable effects. These statements form a comprehensive framework for managing frozen shoulder.
This updated guideline provides evidence-based guidance for managing frozen shoulder and identifies key areas for future research.
英国肘与肩协会（BESS）现行指南于2015年发布，用于指导基层和二级医疗环境中肩周炎的管理。本次更新的指南采用了推荐分级、评估、制定与评价（GRADE）方法。
一个多学科的BESS工作组根据商定的结局指标和时间点确定了关键管理问题。按照PRISMA指南，截至2023年3月进行了文献检索，识别出随机对照试验、系统评价和Meta分析。使用GRADE决策框架进行质量评估，考虑偏倚、不精确性、间接性和不一致性。提取数据进行Meta分析。在缺乏高质量试验的情况下，撰写了叙述性综述。
共识意见基于证据的质量和数量以及预期和非预期效应的大小给出了陈述。这些陈述构成了肩周炎管理的综合框架。
本次更新的指南为肩周炎管理提供了循证指导，并确定了未来研究的关键领域。
