The Pathogenesis and Classification of Shoulder Stiffness

Abstract

The members of the Upper Extremity Committee of ISAKOS meet in Amsterdam in May 2014 with the aim to create a consensus statement on the definition, classification and treatment of the stiff shoulder. The committee recommended that the term “stiff shoulder” is used to describe the patient who presents with a restricted range of motion and that the aetiology can be due to primary or secondary causes. The term “frozen shoulder” is to be used exclusively for idiopathic stiff shoulder and “secondary stiff shoulder” for those cases with a known aetiology. We do not recommend the use of the term adhesive capsulitis.

The committee recommends that the stiff shoulder be classified as intra-articular (cartilage and synovium), capsular and extra-articular. The extra-articular components include the rotator cuff muscle and tendon, but also factors remote to the joint such as heterotopic ossification, burns contracture and neurological causes.

The “shoulder machine” is described with its neurological control, the motor and the articular components of the joint. The stiff shoulder is due to the pathoanatomical consequences of the primary insult, pathological response and secondary insult.

Keywords

Stiff shoulder Frozen shoulder Pathology Aetiology ISAKOS Pathoanatomy 

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Copyright information

© ISAKOS 2015

Authors and Affiliations

  • Gregory I. Bain
    • 1
    • 2
    • 3
    • 4
    • 5
  • Harry D. S. Clitherow
    • 3
    • 4
    • 5
  1. 1.Department of Orthopaedic SurgeryFlinders University of South AustraliaAdelaideAustralia
  2. 2.Department of Orthopaedic SurgeryFlinders Medical CentreAdelaideAustralia
  3. 3.Department of Orthopaedics and TraumaUniversity of AdelaideAdelaideAustralia
  4. 4.Department of Orthopaedics and TraumaRoyal Adelaide HospitalAdelaideAustralia
  5. 5.Department of Orthopaedics and TraumaModbury Public HospitalAdelaideAustralia

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