The puzzling pathophysiology of frozen shoulders - a scoping review

Journal of Experimental Orthopaedics
T KraalR C T Koorevaar

Abstract

The pathophysiology of frozen shoulders is a complex and multifactorial process. The purpose of this review is to scope the currently available knowledge of the pathophysiology of frozen shoulders. A systematic search was conducted in Medline, Embase and the Cochrane library. Original articles published between 1994 and October 2020 with a substantial focus on the pathophysiology of frozen shoulders were included. Out of 827 records, 48 original articles were included for the qualitative synthesis of this review. Glenohumeral capsular biopsies were reported in 30 studies. Fifteen studies investigated were classified as association studies. Three studies investigated the pathophysiology in an animal studies. A state of low grade inflammation, as is associated with diabetes, cardiovascular disease and thyroid disorders, predisposes for the development of frozen shoulder. An early immune response with elevated levels of alarmins and binding to the receptor of advance glycation end products is present at the start of the cascade. Inflammatory cytokines, of which transforming growth factor-β1 has a prominent role, together with mechanical stress stimulates Fibroblast proliferation and differentiation into myofibroblasts. This leads ...Continue Reading

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Citations

Apr 30, 2021·Indian Journal of Orthopaedics·Vivek Pandey, Sandesh Madi
Sep 7, 2021·Rheumatology International·Michel Gcam MertensFilip Struyf
Aug 6, 2021·Journal of Shoulder and Elbow Surgery·Joshua A GordonGeorge R Dodge
Nov 27, 2021·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Miguel Angel Ruiz IbánRafael Lorente Moreno

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Methods Mentioned

BETA
biopsy
ELISA
flow cytometry
PCR
biopsies
transfection
mechanical stress

Software Mentioned

PRISMA

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