Clin Orthop Surg.  2020 Mar;12(1):60-67. 10.4055/cios.2020.12.1.60.

Definition, Diagnosis, Treatment, and Prognosis of Frozen Shoulder: A Consensus Survey of Shoulder Specialists

Affiliations
  • 1Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. osmdkdh@gmail.com
  • 2Department of Rehabilitation Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
  • 3Department of Orthopedic Surgery, The Open Hospital, Daegu, Korea.

Abstract

BACKGROUND
The objective of this study was to identify a consensus on definition, diagnosis, treatment, and prognosis of frozen shoulder (FS) among shoulder specialists.
METHODS
A questionnaire composed of 18 questions about FS"”definition, classification, utilization of diagnostic modalities, the propriety of treatment at each stage, and prognosis"”was sent to 95 shoulder specialists in Korea. Most questions (15 questions) required an answer on a 5-point analog scale (1, strongly disagree; 5, strongly agree); three questions about the propriety of treatment were binary.
RESULTS
We received 71 responses (74.7%). Of the 71 respondents, 84.5% agreed with the proposed definition of FS, and 88.8% agreed that FS should be divided into primary and secondary types according to the proposed definition. Only 43.7% of the respondents agreed that FS in patients with systemic disease should be classified as secondary FS. For the diagnosis of FS, 71.9% agreed that plain radiography should be used and 64.8% agreed ultrasonography should be used. There was a high consensus on proper treatment of FS: 97.2% agreed on education, 94.4%, on the use of nonsteroidal anti-inflammatory drugs; 76.1%, on intra-articular steroid injections; and 97.2%, on stretching exercise. Among all respondents, 22.5% answered that more than 10% of the patients with FS do not respond to conservative treatment.
CONCLUSIONS
The survey revealed a general consensus among shoulder specialists on the definition and treatment of FS. However, classification of FS was found controversial.

Keyword

Frozen shoulder; Definition; Classification; Diagnosis; Treatment

MeSH Terms

Bursitis*
Classification
Consensus*
Diagnosis*
Education
Humans
Korea
Prognosis*
Radiography
Shoulder*
Specialization*
Surveys and Questionnaires
Ultrasonography
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