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Identification of prognostic factors for the nonoperative treatment of stiff shoulder

International Orthopaedics volume 37, pages 859–864 (2013)Cite this article

Abstract

Purpose

This study evaluated prognostic factors for the nonoperative treatment of stiff shoulder.

Methods

Between June 2005 and May 2010, 497 stiff shoulders treated at our institute were included in this study. Multivariable analysis for recovery with Cox proportional hazard model was performed. The chief determining variable was pathogenesis (idiopathic, diabetic, post-traumatic) and confounding variables were age (49 or less, 50–59, 60 and above), sex, onset to visit interval (three months or less, four months or more), and external rotation (under 0°, 0° or more) or forward flexion (less than 90°, 90° or more) or internal rotation on the first visit.

Results

There were 356 idiopathic, 61 diabetic, and 80 post-traumatic stiff shoulders. Hazard ratio (HR) and 95 % confidence interval (CI) for recovery (lower HR means poor prognosis) was 0.54 (0.36–0.96) in the diabetic group (p = 0.007), and 0.92 (0.67–1.25) in the post-traumatic group (p = 0.58) compared with the idiopathic group. A positive correlation was observed in ages of 60 or over (HR 1.46, 95 % CI 0.86–1.65, p-value 0.02) and external rotation under 0° on the first visit (0.71, 0.53–0.96, 0.03). No correlations were observed in sex (p = 0.78) or onset to visit interval (p = 0.99). Similar results were obtained when forward flexion or internal rotation was used as a confounding variable.

Conclusions

Diabetes mellitus and severely restricted joint motion on the first visit were poor prognostic factors and ages of 60 or over was a better prognostic factor.

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Conflict of interests

The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan

    Akira Ando, Yoshihiro Hagiwara, Kenji Kanazawa & Eiji Itoi

  2. Funabashi Orthopaedic Sports Medicine Center, 1-833 Hazama, Funabashi, Japan

    Hiroyuki Sugaya & Norimasa Takahashi

  3. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, Japan

    Takashi Watanabe

Authors
  1. Akira Ando
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  2. Hiroyuki Sugaya
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  3. Yoshihiro Hagiwara
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  4. Norimasa Takahashi
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  5. Takashi Watanabe
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  6. Kenji Kanazawa
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  7. Eiji Itoi
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Corresponding author

Correspondence to Yoshihiro Hagiwara.

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Level of evidence

Treatment Study Level III (Retrospective comparative study).

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Ando, A., Sugaya, H., Hagiwara, Y. et al. Identification of prognostic factors for the nonoperative treatment of stiff shoulder. International Orthopaedics (SICOT) 37, 859–864 (2013). https://doi.org/10.1007/s00264-013-1859-8

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  • DOI: https://doi.org/10.1007/s00264-013-1859-8

Keywords

  • Rotator Cuff
  • Osteonecrosis
  • Internal Rotation
  • External Rotation
  • Humeral Head