Leppälä J, Kannus P, Sievänen H, Järvinen M, Vuori I
Accident and Trauma Research Center, UKK Institute for Health Promotion Research, Tampere, Finland.
Bone. 1998 Jun;22(6):691-4. doi: 10.1016/s8756-3282(98)00049-0.
The objective of the study was to assess the short- and long-term effects of adhesive capsulitis (frozen shoulder) on the bone mineral density (BMD) of the affected extremity. BMD and clinical status of 22 patients (group A) with active-phase unilateral adhesive capsulitis and 31 patients (group B) with a previous adhesive capsulitis (average 9 years before the examination) were determined. BMD was measured from the proximal humerus, humeral shaft, radial shaft, ulnar shaft, and distal forearm of both upper extremities using dual-energy X-ray absorptiometry (DXA). In group A, the mean BMD of the affected extremity, as compared with that of the unaffected side, was significantly lower in the proximal humerus (-5.6%; p = 0.001) and humeral shaft (-3.0%; p = 0.008). The radial shaft, ulnar shaft, and distal forearm showed no significant side-to-side differences. In contrast, in group B, the affected-to-unaffected side BMD differences were small and statistically insignificant. Compared with the 31 patients in group B, the relative side-to-side BMD difference of the 22 patients with active-phase disease (group A) was significantly lower in the proximal humerus (-5.6% vs. -1.5%, p = 0.009). In the other sites, groups A and B showed no significant differences. In conclusion, this study indicates that adhesive capsulitis of the shoulder results in significant bone loss in the humerus of the affected extremity, but in the long term, capsulitis-induced bone loss shows good recovery.
该研究的目的是评估粘连性关节囊炎（肩周炎）对患侧肢体骨密度（BMD）的短期和长期影响。测定了22例单侧粘连性关节囊炎急性期患者（A组）和31例既往有粘连性关节囊炎患者（检查前平均9年，B组）的骨密度和临床状况。使用双能X线吸收法（DXA）测量双侧上肢肱骨近端、肱骨干、桡骨干、尺骨干和前臂远端的骨密度。在A组中，患侧肢体的平均骨密度与未受影响侧相比，肱骨近端显著降低（-5.6%；p = 0.001），肱骨干也显著降低（-3.0%；p = 0.008）。桡骨干、尺骨干和前臂远端未显示出显著的左右差异。相比之下，在B组中，患侧与未患侧的骨密度差异较小且无统计学意义。与B组的31例患者相比，22例急性期疾病患者（A组）的相对左右骨密度差异在肱骨近端显著更低（-5.6%对-1.5%，p = 0.009）。在其他部位，A组和B组未显示出显著差异。总之，本研究表明肩部粘连性关节囊炎会导致患侧肢体肱骨出现显著骨质流失，但从长期来看，关节囊炎引起的骨质流失显示出良好的恢复情况。
