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Incidence and prognostic factors for postoperative frozen shoulder after shoulder surgery: a prospective cohort study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Frozen shoulder is a potential complication after shoulder surgery. It is a clinical condition that is often associated with marked disability and can have a profound effect on the patient’s quality of life. The incidence, etiology, pathology and prognostic factors of postoperative frozen shoulder after shoulder surgery are not known. The purpose of this explorative study was to determine the incidence of postoperative frozen shoulder after various operative shoulder procedures. A second aim was to identify prognostic factors for postoperative frozen shoulder after shoulder surgery.

Methods

505 consecutive patients undergoing elective shoulder surgery were included in this prospective cohort study. Follow-up was 6 months after surgery. A prediction model was developed to identify prognostic factors for postoperative frozen shoulder after shoulder surgery using the TRIPOD guidelines. We nominated five potential predictors: gender, diabetes mellitus, type of physiotherapy, arthroscopic surgery and DASH score.

Results

Frozen shoulder was identified in 11% of the patients after shoulder surgery and was more common in females (15%) than in males (8%). Frozen shoulder was encountered after all types of operative procedures. A prediction model based on four variables (diabetes mellitus, specialized shoulder physiotherapy, arthroscopic surgery and DASH score) discriminated reasonably well with an AUC of 0.712.

Conclusions

Postoperative frozen shoulder is a serious complication after shoulder surgery, with an incidence of 11%. Four prognostic factors were identified for postoperative frozen shoulder: diabetes mellitus, arthroscopic surgery, specialized shoulder physiotherapy and DASH score. The combination of these four variables provided a prediction rule for postoperative frozen shoulder with reasonable fit.

Level of evidence

Level II, prospective cohort study.

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Acknowledgements

We thank Marleen Jaspers, physiotherapist, and Hannie Elskamp, orthopedic research nurse, who helped with data collection.

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Authors and Affiliations

  1. Department of Orthopedics, Deventer Hospital, N. Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands

    Rinco C. T. Koorevaar

  2. Teaching Hospital/Research Department, Deventer Hospital, N. Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands

    Esther van‘t Riet

  3. Department of Physiotherapy, Deventer Hospital, N. Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands

    Marcel Ipskamp

  4. Department of Orthopedics, University Medical Center Groningen, University of Groningen, PO box 30.001, 9700 GB, Groningen, The Netherlands

    Sjoerd K. Bulstra

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  1. Rinco C. T. Koorevaar
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Corresponding author

Correspondence to Rinco C. T. Koorevaar.

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The authors declare that they have no conflict of interest.

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All authors declare that they received no funding or financial support for this study.

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Koorevaar, R.C.T., van‘t Riet, E., Ipskamp, M. et al. Incidence and prognostic factors for postoperative frozen shoulder after shoulder surgery: a prospective cohort study. Arch Orthop Trauma Surg 137, 293–301 (2017). https://doi.org/10.1007/s00402-016-2589-3

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  • DOI: https://doi.org/10.1007/s00402-016-2589-3

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