Shoulder and Elbow最新文献

{"title":"Predictors of operating room time in shoulder arthroplasty for glenohumeral osteoarthritis.","authors":"William E Harkin, Jay M Levin, Tyler Williams, Zeeshan A Khan, Alexander Hornung, Gregory P Nicholson, Christopher S Klifto, Grant E Garrigues","doi":"10.1177/17585732251343859","DOIUrl":"10.1177/17585732251343859","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to identify risk factors for prolonged operative duration in anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) for patients with glenohumeral osteoarthritis (GHOA).</p><p><strong>Methods: </strong>A retrospective chart review of electronic medical records was conducted to identify patients who underwent shoulder arthroplasty for GHOA by one of six surgeons across two academic institutions between 2017 and 2023. Multivariate linear regression was used to identify factors associated with operative duration.</p><p><strong>Results: </strong>In total, 513 patients underwent primary ATSA, and 528 underwent primary RTSA. The mean operating room (OR) time was significantly longer in patients undergoing ATSA (183.5 ± 39.5 minutes) compared to those undergoing RTSA (150.5 ± 33.4 minutes). For ATSA, older patient age, male sex, increased body mass index, lower Charlson comorbidity index (CCI), increased preoperative retroversion, increased preoperative inclination, and a glenoid Walch classification of B2 or B3 were significant predictors of OR time. For RTSA, younger patient age, lower CCI, and increased preoperative retroversion were significant predictors of OR time.</p><p><strong>Conclusion: </strong>ATSA has a significantly longer mean OR time than RTSA for the treatment of isolated GHOA. Preoperative demographic and radiographic data can be used to predict operative duration.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251343859"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortened length of stay and its impact on total shoulder arthroplasty expenses.","authors":"William ElNemer, Arman Kishan, Henry M Fox, Sarah Nelson, Gergo B Merkely, Nicholas A Alfonso, Nikolaos K Paschos, Matthew J Best, Uma Srikumaran","doi":"10.1177/17585732251344159","DOIUrl":"10.1177/17585732251344159","url":null,"abstract":"<p><strong>Background: </strong>The volume of both anatomic and reverse total shoulder arthroplasty (TSA) has increased in the United States over the last decade. A reduction in length of stay (LOS) postoperatively is a clear way to reduce hospital costs and labor burden. This study aimed to quantify how the LOS reduction has impacted inpatient TSA costs.</p><p><strong>Methods: </strong>The study queried the National Inpatient Sample (NIS) database to identify individuals undergoing inpatient elective TSA for osteoarthritis from 2012 to 2020. Total costs were determined by multiplying the hospital's cost-to-charge ratio from NIS by the total charges, inflation-adjusted to 2020. Bivariate linear regression assessed the LOS trend, and multivariate gamma regression with log link modeled TSA total cost and charge, adjusting for patient variables and operational year. Predicted total cost and charge were plotted postmodel fitting. Additionally, LOS was standardized to the 2012 mean for model predictions.</p><p><strong>Results: </strong>Numbers are reported as national estimates. In all, 527,300 patients were identified with an average age of 69 years, and 47% were male. The average LOS in 2012 was two days and had a decreasing trend to 1.2 days in 2020 (ß = -0.01, <i>p</i> < .001). Multivariate analysis revealed that increased LOS postoperatively was an independent predictor of increased total charges and costs of surgery after adjustment for covariates including overall health of the patient. Between 2012 and 2020, there was an observed increase in total costs despite accounting for the decrease in LOS. The total costs of surgery would have increased 11.8% ($18,597.03 to $20,792.84) from 2012 to 2020 if surgeons maintained the 2012 LOS; total costs would have increased 5.5% ($18,597.03 to $19,628.92) from 2012 to 2020.</p><p><strong>Conclusion: </strong>Total hospital costs for total shoulder replacement increased by 23% from 2012 to 2020. This increase in total cost was simultaneously dampened by the concurrent reduction in LOS, from 2 days to 1.2 days. By recognizing the tangible link between shorter lengths of stay and economic savings, healthcare institutions can make informed decisions that promote both fiscal responsibility and quality patient care.<b>Level of Evidence::</b> 3.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251344159"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder injuries in elite female cricket players: Insights from eight seasons.","authors":"Gordon Pritchard, Pallavi Deshmukh, Anna E Saw, Kate Beerworth, Kevin Sims","doi":"10.1177/17585732251344257","DOIUrl":"10.1177/17585732251344257","url":null,"abstract":"<p><strong>Background: </strong>Shoulder injuries are a key injury for elite cricket players; however, the burden is not well understood. This study describes the incidence, prevalence, characteristics and management of medical attention shoulder injuries in elite female cricket players.</p><p><strong>Methods: </strong>Retrospective review of shoulder injuries sustained by elite Australian female cricket players between July 2015 and June 2023.</p><p><strong>Results: </strong>A total of 409 medical attention shoulder injuries were recorded, with an average incidence of 12.9 per 100 players per season. Gradual onset injuries were most commonly experienced by pace bowlers (51%). Sudden onset injuries were most commonly sustained whilst fielding (69%). Four in five injuries were non-time-loss. Modified activities (e.g., throwing, diving and bowling) were typically required for between two weeks and six months. Players typically returned to full unrestricted match play between 1 and 8.5 months, longer for recurrent injuries (<i>p</i> = 0.007).</p><p><strong>Discussion: </strong>Despite only one in five injuries resulting in a player being unavailable to play or train, impaired shoulder function may reduce the overall performance of the player and the team. Risk reduction strategies may be targeted to players (pace bowlers) and activities (diving and throwing) with a higher rate of shoulder injury. Further consideration may also be given to reducing the risk of exacerbations and recurrent injuries which may prolong recovery.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251344257"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between pain, stiffness, mood, catastrophizing, and perceived social support, in subjects with frozen shoulder: A cross-sectional study.","authors":"Fabrizio Brindisino, Valentina Rizzo, Beate Dejaco, Arianna Andriesse, Angela Verardo, Andrea Turolla","doi":"10.1177/17585732251338652","DOIUrl":"https://doi.org/10.1177/17585732251338652","url":null,"abstract":"<p><strong>Introduction: </strong>Catastrophizing, mood disturbances, and low perceived social support are frequently reported in individuals with frozen shoulder (FS). This study aimed to investigate the associations between pain, perceived stiffness, mood, catastrophizing, and perceived social support in individuals with FS.</p><p><strong>Methods: </strong>This cross-sectional exploratory online survey adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Participants clinically diagnosed with FS based on Kelley's criteria completed the questionnaire via Google Forms.</p><p><strong>Results: </strong>Higher daytime pain was significantly associated with feelings of anger (<i>p</i> = 0.025) and sadness (<i>p</i> = 0.031). Catastrophizing thoughts, for example, \"I will not be able to raise my arms as before,\" were correlated with increased daytime pain (<i>p</i> = 0.039), while \"the pain will never end\" was associated with both daytime (<i>p</i> = 0.007) and night-time pain (<i>p</i> < 0.001). Perceptions of low social support, for example, \"nobody understands my situation\" were linked to higher daytime pain (<i>p</i> = 0.007), and greater night-time pain (<i>p</i> < 0.05). Perceived stiffness was significantly associated with seeking psychological support during episodes of demoralization (<i>p</i> = 0.029).</p><p><strong>Discussion: </strong>Psychological factors significantly influence pain and stiffness perceptions in FS, emphasizing the need for clinicians to address both physical and emotional aspects of recovery. A multidisciplinary approach should therefore be considered to provide comprehensive care.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251338652"},"PeriodicalIF":1.5,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of graded motor imagery training on pain and functionality in patients with subacromial pain syndrome: A prospective, single-blind, randomized controlled trial.","authors":"Masoud Amir Rashedi Bonab, Tugba Kuru Colak, Ilker Colak, Ihsan Ozdamar","doi":"10.1177/17585732251340327","DOIUrl":"https://doi.org/10.1177/17585732251340327","url":null,"abstract":"<p><strong>Background: </strong>Pain from subacromial pain syndrome (SAPS) can limit individuals' daily activities and reduce physical performance. The effectiveness of graded motor imagery (GMI) training for this condition remains unexplored. This prospective, randomized controlled trial aimed to determine the effects of GMI training in patients with chronic painful SAPS.</p><p><strong>Methods: </strong>Forty-two patients with SAPS were randomly assigned to the GMI (n = 21) and the control (n = 21) groups. Primary measures were the visual analogue scale (VAS), and the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary measures were Active Range of Motion (AROM), muscle strength, lateralization performance and Kinesthetic and Visual Imagery Questionnaire (KVIQ). Evaluations occurred at baseline, postintervention (6 weeks), and after a 6-week follow up.</p><p><strong>Results: </strong>The GMI group showed significantly greater improvements in both primary and secondary outcomes compared to the control group (p < 0.001). Significantly larger effect sizes were found in favor of the GMI group for VAS, DASH, abduction, external rotation AROM, muscle strength, lateralization performance, and KVIQ (ηp² < 0.14, p < 0.05, for all).</p><p><strong>Conclusions: </strong>The integration of GMI training into conventional physiotherapy for SAPS rehabilitation provides more effective clinical results in improving pain intensity and increasing functionality.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251340327"},"PeriodicalIF":1.5,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving outcomes in shoulder arthroplasty: A case series on the GPS-navigated bulk humeral autograft technique.","authors":"Chase Walton, Robert J Reis, Brandon Rogalski, Richard J Friedman, Josef K Eichinger","doi":"10.1177/17585732251339744","DOIUrl":"https://doi.org/10.1177/17585732251339744","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this case series is to evaluate the efficacy and safety of the GPS-navigated humeral head (HH) autograft technique in the setting of primary reverse total shoulder arthroplasty (rTSA) for severe glenoid bone loss.</p><p><strong>Methods: </strong>A database of prospectively enrolled patients was reviewed to identify patients who underwent GPS navigated primary rTSA with HH autograft (<i>N</i> = 8). Variables collected pre-operatively and at last follow up included demographics, active range of motion (ROM), patient reported outcome measures radiographic measures, complications, and revisions.</p><p><strong>Results: </strong>Mean age was 59.5 (range: 45-80), mean BMI was 26.8 (range: 18-37) and 5 patients were male. At final follow up (median: 24 months), patients had a mean increase in forward flexion of 44 (<i>p</i> = 0.003), external rotation of 27 (<i>p</i> = 0.039), internal rotation score of 1.1 (<i>p</i> = 0.048), global function score of 4.8 (<i>p</i> < 0.001), American Shoulder and Elbow Surgeons score of 44 (<i>p</i> < 0.001), and decrease in visual analog scale pain of 5 (<i>p</i> < 0.001). Two patients had evidence of glenoid component loosening at 3 years post-operatively, however only one was symptomatic requiring a revision operation.</p><p><strong>Discussion: </strong>Our findings demonstrate significant improvement in ROM, pain relief, and shoulder function following GPS-navigated primary rTSA with bulk HH autograft.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251339744"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified frailty index is a useful predictor for complications following total elbow arthroplasty in all populations.","authors":"Bruce Tanner Seibold, Campbell Dopke, Theodore Quan, Sabrina Gill, Zachary Zimmer","doi":"10.1177/17585732251338764","DOIUrl":"https://doi.org/10.1177/17585732251338764","url":null,"abstract":"<p><strong>Background: </strong>This retrospective review aimed to specify whether the 5-item modified frailty index (mFI-5) is a valid measure for surgeons when assessing the likelihood of complications in patients undergoing total elbow arthroplasty (TEA).</p><p><strong>Methods: </strong>TEA patients 50 years or older were identified from the NSQIP database from 2006 to 2019. Patients were stratified based on age to create a 50+, a 65+, and an 80-89-year-old cohort. Thirty-day outcomes assessed in this study included mortality, unplanned readmission, return to the operating room, urinary tract infection, bleeding requiring transfusion, prolonged hospital stay, and discharge to a location other than home. The mFI-5 was calculated based on the sum of the presence of five comorbidities. Bivariate and multivariate analyses compared the complication rates among mFI-5 scores.</p><p><strong>Results: </strong>The study included a total of 614 TEA patients aged 50 years or older. Following adjustment, patients older than 50 with mFI-5 = 1 had an increased risk of being discharged to a non-home location compared to patients with mFI-5 = 0 (odds ratio (OR) 3.27). Compared to patients with mFI-5 = 0, those with mFI-5 = 2 or greater had an increased risk of bleeding requiring transfusion (OR 5.13), prolonged hospital stay (> 5 days) (OR 5.83), and discharge to a non-home destination (OR 9.88). Relative to patients with mFI-5 = 1, those with mFI-5 = 2 or greater were more likely to have prolonged hospital stay (OR 3.07) and discharge to a non-home location (OR 3.05). Patients older than 65 and patients in the 80-89-year-old cohort with mFI-5 = 2 were also more likely to have a non-home discharge (OR 10.40 and 21.84, respectively).</p><p><strong>Conclusion: </strong>Higher mFI-5 scores in patients aged 50 and older were associated with worse postoperative outcomes including non-home discharge, transfusion likelihood, and prolonged hospitalization. Similar trends were observed in both the 65 + and 80-89-year-old cohorts regarding the risk of non-home discharge, however, higher mFI-5 scores in these older groups did not have an increased likelihood of postoperative transfusion or prolonged hospital stay.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251338764"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Thrower's Ten program's effect on shoulder flexibility, stability, and strength in water polo athletes.","authors":"Burak Asal, Nihan Özünlü Pekyavas","doi":"10.1177/17585732251335933","DOIUrl":"https://doi.org/10.1177/17585732251335933","url":null,"abstract":"<p><strong>Context: </strong>The Thrower's Ten (T10) rehabilitation program is proven effective in preventing and rehabilitating injuries in overhead throwing sports. Its effect on water polo athletes remains unclear.</p><p><strong>Methods: </strong>This study involved 46 water polo athletes (age = 16.89 ± 2.89 years, height = 173.09 ± 9.40 cm, mass = 64.50 ± 11.96 kg, BMI = 21.39 ± 2.81 kg/m²) randomized into T10 and control groups. The T10 group performed T10 exercises three times weekly for 10 weeks, with each exercise consisting of 2 × 10 repetitions. The control group followed regular water polo training without additional exercises. Assessments were conducted before and after the intervention, measuring upper extremity internal and external rotation strength with an isokinetic dynamometer, shoulder stability using the Closed Kinetic Chain Upper Extremity Test (CKCUEST), and shoulder flexibility through internal and external rotation range of motion tests.</p><p><strong>Results: </strong>The T10 group showed significant improvements in CKCUEST scores, shoulder flexibility, and non-dominant extremity internal rotation strength compared to pre-intervention values (<i>P</i> < 0.05). In CKCUEST average touches and normalized score measurements, the T10 group performed significantly better than the control group (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>T10 exercises enhanced stability and flexibility in water polo athletes, with partial effectiveness in improving strength.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251335933"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The deltoid abduction lag test for assessment of axillary nerve injury and functional deltoid recovery.","authors":"Ashley I Simpson, Rory Cuthbert, Michael Fox","doi":"10.1177/17585732251336183","DOIUrl":"https://doi.org/10.1177/17585732251336183","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis and assessment of functional deltoid recovery following axillary nerve injury is challenging due to numerous other muscular contributions to shoulder movement - particularly supraspinatus, rhomboids and long head of triceps. We present the deltoid abduction lag test (DALT) which offers four clear benefits: 1) it successfully isolates deltoid in the presence of a functioning supraspinatus with intact tendon and attachment; 2) it is safe to perform early following anterior shoulder dislocation (the most common cause of axillary nerve injury); 3) it allows assessment of early functional reinnervation of posterior deltoid to aid decision-making with respect to surgical intervention; 4) it is an objective measure which does not rely on patient compliance with initiation of active movement.</p><p><strong>Methods: </strong>A retrospective review of consecutive patients referred with axillary nerve injury to a national centre for Peripheral Nerve Injury between 2014 and 2024 was conducted. Inclusion criteria was isolated persistent axillary nerve injury confirmed on neurophysiological testing with intact rotator cuff, rhomboid and triceps function. Patients who had undergone prior nerve transfer to address axillary nerve injury were excluded. Patients were independently assessed by two orthopaedic surgeons and a Cohen's kappa (κ) value was calculated to assess inter-rater reliability. The DALT was performed with a goniometer used to measure degree of lag comparative to the coronal plane. Passive range of shoulder movement, rotator cuff / triceps / rhomboid power, upper lateral cutaneous nerve sensation, swallow-tail test, deltoid extension lag test, 'akimbo' test and Bertelli test were documented for both shoulders.</p><p><strong>Results: </strong>Six patients with a mean age of 36 (15-68) were included. The DALT was positive in all cases of ongoing axillary nerve palsy. There was no discrepancy between both surgeons' independent clinical interpretation of the DALT.</p><p><strong>Conclusion: </strong>The DALT successfully and reproducibly isolates deltoid function and identifies axillary nerve palsy. We specifically advocate using this test immediately following injury to confirm the presence of an axillary nerve lesion, at 3 months post-injury to identify patients who have experienced a neurapraxic injury and at 6 months to identify axonal lesions which may benefit from surgical intervention.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251336183"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Elbow and Shoulder Society patient care pathway: Frozen shoulder.","authors":"Neal Rupani, Steve E Gwilym","doi":"10.1177/17585732251335955","DOIUrl":"https://doi.org/10.1177/17585732251335955","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>This updated guideline provides evidence-based guidance for managing frozen shoulder and identifies key areas for future research.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251335955"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}