Risk Factors For Adhesive Capsulitis Research Articles

Prevalence of and Risk Factors for Adhesive Capsulitis of the Shoulder in Older Adults from Germany.

This study aimed to investigate the prevalence of and risk factors for adhesive capsulitis in older adults from Germany. The one-year and lifetime prevalence of adhesive capsulitis were assessed in adults aged ≥65 years with at least one visit to one of 1207 general practices in Germany in 2021. Associations between physical and psychiatric conditions and adhesive capsulitis were further assessed in older patients diagnosed for the first time with adhesive capsulitis in general practices in 2010-2021 (index date) and matched (1:5) to patients without adhesive capsulitis using a propensity score based on age, sex, and the index year. In adults without adhesive capsulitis, the index date was a randomly selected visit date in 2010-2021. The one-year and lifetime prevalence of adhesive capsulitis in older adults in 2021 were 0.4% and 2.4%, respectively. In 8439 patients with and 42,195 patients without adhesive capsulitis, 12 conditions were positively and significantly associated with adhesive capsulitis. Effect sizes were strongest for other and unspecified osteoarthritis (OR = 1.93), injury to the shoulder and upper arm (OR = 1.85), and injury to the thorax (OR = 1.47). Based on these findings, adhesive capsulitis can occur at older age, and osteoarthritis and injuries are major risk factors.

Genome-Wide Association Study of Adhesive Capsulitis Suggests Significant Genetic Risk Factors.

Adhesive capsulitis of the shoulder involves loss of passive range of motion with associated pain and can develop spontaneously, with no obvious injury or inciting event. The pathomechanism of this disorder remains to be elucidated, but known risk factors for adhesive capsulitis include diabetes, female sex, and thyroid dysfunction. Additionally, transcriptional profiling and pedigree analyses have suggested a role for genetics. Identification of elements of genetic risk for adhesive capsulitis using population-based techniques can provide the basis for guiding both the personalized treatment of patients based on their genetic profiles and the development of new treatments by identification of the pathomechanism. A genome-wide association study (GWAS) was conducted using the U.K. Biobank (a collection of approximately 500,000 patients with genetic data and associated ICD-10 [International Classification of Diseases, 10th Revision] codes), comparing 2,142 patients with the ICD-10 code for adhesive capsulitis (M750) to those without. Separate GWASs were conducted controlling for 2 of the known risk factors of adhesive capsulitis-hypothyroidism and diabetes. Logistic regression analysis was conducted controlling for factors including sex, thyroid dysfunction, diabetes, shoulder dislocation, smoking, and genetics. Three loci of significance were identified: rs34315830 (in WNT7B; odds ratio [OR] = 1.28; 95% confidence interval [CI], 1.22 to 1.39), rs2965196 (in MAU2; OR = 1.67; 95% CI, 1.39 to 2.00), and rs1912256 (in POU1F1; OR = 1.22; 95% CI, 1.14 to 1.31). These loci retained significance when controlling for thyroid dysfunction and diabetes. The OR for total genetic risk was 5.81 (95% CI, 4.08 to 8.31), compared with 1.70 (95% CI, 1.18 to 2.36) for hypothyroidism and 4.23 (95% CI, 2.32 to 7.05) for diabetes. The total genetic risk associated with adhesive capsulitis was significant and similar to the risks associated with hypothyroidism and diabetes. Identification of WNT7B, POU1F1, and MAU2 implicates the Wnt pathway and cell proliferation response in the pathomechanism of adhesive capsulitis. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Is routine gleno-humeral exploration a risk factor for adhesive capsulitis after arthroscopic removal of rotator cuff calcifications? A comparative retrospective study in 340 cases

BackgroundArthroscopic surgery has earned its place as the reference standard treatment for rotator cuff calcific tendinopathy refractory to conservative medical treatment. Adhesive capsulitis of the shoulder is the most common complication (12%). Standard practice involves routine gleno-humeral exploration before calcification removal. The objective of this study was to identify risk factors for adhesive capsulitis. HypothesisThe development of adhesive capsulitis is associated with gleno-humeral exploration. MethodsWe conducted a multicentre, multi-surgeon, retrospective cohort study of 340 consecutive patients who underwent arthroscopic removal of rotator cuff calcifications between 1 January 2012 and 1 January 2018. We collected epidemiological data (age, sex, work-related physical activity), the history of previous treatments (local injections, needling), the type and location of the calcifications as assessed radiologically, the clinical findings (Constant score before and 6 months after surgery, diagnosis of adhesive capsulitis defined as shoulder pain with motion range limitation in all directions), and the surgical details (type of anaesthesia, gleno-humeral exploration). ResultsOf the 340 patients, 251 underwent routine gleno-humeral exploration and 89 did not. Adhesive capsulitis developed in 40 (12%) patients. By multivariate analysis, gleno-humeral exploration was an independent risk factor for adhesive capsulitis (p=0.022; odds ratio, 5.60). Of the 251 gleno-humeral explorations, 8% identified concomitant lesions and only 4% led to a curative procedure. ConclusionGiven our results and the data in the literature, we believe that routine gleno-humeral exploration during the arthroscopic treatment of rotator cuff calcific tendinopathy is inadvisable. Level of evidenceIII; case-control study.

Prevalence and Risk Factors of Adhesive Capsulitis in Asian Breast Cancer Patients Undergoing an Outpatient Community Cancer Rehabilitation Program

ObjectivesTo investigate the prevalence and risk factors for adhesive capsulitis in postoperative breast cancer patients up to 5 years after surgery who were attending an outpatient community cancer rehabilitation program, and to determine whether any significant relationship exists between arm lymphedema and adhesive capsulitis. DesignCross-sectional observational study. SettingNational cancer rehabilitation center. ParticipantsAsian women (N=135) who underwent breast surgery and were referred for an outpatient community cancer rehabilitation program. InterventionsNot applicable. Main Outcome MeasuresPresence of adhesive capsulitis, lymphedema. ResultsThe prevalence of adhesive capsulitis and lymphedema in this population was 22.2% and 33.3%, respectively. A history of mastectomy (odds ratio [OR], 3.93; 95% confidence interval [CI], 1.23-12.63; P=.021), mastectomy with reconstruction (OR, 2.72; 95% CI, 1.27-30.54; P=.024), and lymphedema (OR, 7.92; 95% CI, 2.73-22.95; P<.001) were found to be significantly associated with adhesive capsulitis on multivariate analysis. ConclusionsAdhesive capsulitis and lymphedema are common in breast cancer survivors. The design of cancer rehabilitation programs for breast cancer survivors should include surveillance and management of adhesive capsulitis, especially in the presence of lymphedema.

Association between fasting glucose levels and adhesive capsulitis in a normoglycemic population: a case-control study

Hyperglycemia is the most commonly cited risk factor for adhesive capsulitis. However, no study has established whether fasting glucose levels within the normoglycemic range are associated with idiopathic adhesive capsulitis (IAC). This study hypothesized that increments of fasting glucose levels within the normoglycemic range would be linked to IAC. This study investigated any association between normoglycemic fasting glucose levels and IAC. This case-control study comprised a group of 151 patients with IAC without intrinsic shoulder lesions, extrinsic causes, or known metabolic risk factors such as diabetes, dyslipidemia, and thyroid dysfunction. The control group comprised 453 age- and sex-matched persons seeking general check-ups at the authors' health promotion center during the same period as the case group. Control subjects had normal shoulder function, no previous diagnosis of adhesive capsulitis or of metabolic disease, and no history of trauma or of shoulder surgery. The studied variables were body mass index, serum lipid profiles, thyroid hormone levels, fasting glucose levels, glycosylated hemoglobin A1c, and high-sensitivity C-reactive protein. Fasting glucose levels were studied as scale data and categorical data (<85, 85-89, 90-94, and 95-99 mg/dL). Multivariable conditional logistic regression analysis evaluated the matched sets of subjects. Odds ratiosand 95% confidence intervalswere determined for various potentially associated factors. Fasting glucose level, hypercholesterolemia, and high-sensitivity C-reactive protein were significantly associated with IAC (P ≤ .030). Fasting glucose levels in the <85 mg/dL quartile were significantly negatively associated with IAC (P ≤ .001). In contrast, fasting glucose levels in the 90-94 mg/dL quartile or higher were significantly positively associated with IAC (P ≤ .034). IAC is positively associated with fasting glucose levels of 90-99 mg/dL, which are currently considered normoglycemic.

Patients with Axial Spondyloarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan.

Patients with axial spondyloarthritis (ax-SpA) present with inflammation invading the axial skeleton. Symptoms of ax-SpA interfere with patients’ quality of life, and peripheral symptoms are also noted. Human leukocyte antigen B27 was associated with adhesive capsulitis. However, epidemiological studies investigating the associated incidence and risk factors for patients with ax-SpA with adhesive capsulitis are limited. The data of patients with ax-SpA were recorded during the 2004–2008 period and followed to the end of 2010. The control cohort comprised age- and sex-matched non-ax-SpA subjects. A Cox multivariate proportional hazards model was applied to analyze the risk factors for adhesive capsulitis. The hazard ratio (HR) and adjusted hazard ratio (aHR) were estimated between the study and control cohorts after confounders were adjusted for. Effects of sulfasalazine (SSZ), methotrexate (MTX), and hydroxychloroquine (HCQ) use on adhesive capsulitis risk were also analyzed. We enrolled 2859 patients with ax-SpA in the study cohort and 11,436 control subjects. A higher incidence of adhesive capsulitis was revealed in the ax-SpA cohort: The crude HR was 1.63 (95% CI, 1.24–2.13; p < 0.001), and the aHR was 1.54 (95% CI, 1.16–2.05; p = 0.002). For patients with ax-SpA using SSZ or HCQ, no difference in aHR was noted compared with control participants, but patients with ax-SpA treated with MTX had higher HR and aHR than controls. Patients with ax-SpA are at risk for adhesive capsulitis. When these patients receive SSZ or HCQ, the risk of adhesive capsulitis can be lowered compared with that of the control cohort.

Risk factors for adhesive capsulitis requiring shoulder arthroscopy: A clinical retrospective case series study

Risk factors for adhesive capsulitis requiring shoulder arthroscopy: A clinical retrospective case series study

Asian ethnicity: a risk factor for adhesive capsulitis?

ObjectiveThe aim of this study was to evaluate whether Asian ethnicity is a risk factor for the development of adhesive capsulitis. The secondary aim was to describe the distribution of cases of capsulitis by age group. MethodsA cross-sectional study comparing the rate of adhesive capsulitis in individuals of Asian ethnicity with that of other ethnicities. We excluded patients with fractures and those with symptoms not involving the shoulder. The odds ratio was adjusted for confounding factors by binary logistic regression. ResultsA total of 1331 patient records were evaluated and after applying the selection criteria, 814 patients remained. We found 134 cases of adhesive capsulitis (15.6%). The peak of incidence was at 60–64 years in the patients of Asian ethnicity and at 55–59 years in the other patients. The unadjusted odds ratio was 4.2 (CI 95%, 2.4–7.4), while the odds ratio adjusted for sex and diabetes mellitus was 3.6 (CI 95%, 2.0–6.5). ConclusionPatients of Asian ethnicity showed an independent risk factor for the development of adhesive capsulitis, with an adjusted odds ratio of 3.6. Adhesive capsulitis was more common between 55 and 64 years.

Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment.

The present study investigated the prevalence and risk factors of adhesive capsulitis of the shoulder in breast cancer patients between 13 and 18months after surgery. This study included 271 women who underwent surgery for breast cancer with a postoperative period of 13-18months. Current adhesive capsulitis was defined as restriction of external rotation and one or more additional directional restrictions with history of shoulder pain. Cumulative adhesive capsulitis was defined as current adhesive capsulitis or a previous history of adhesive capsulitis after breast cancer surgery. Multivariate logistic regression analysis was performed to examine associations between current or cumulative adhesive capsulitis and potential risk factors. Among the 271 study patients, 28 (10.3%) and 21 (7.7%) had cumulative or current adhesive capsulitis, respectively. The incidences of cumulative and current adhesive capsulitis were higher in those aged 50-59years (odds ratio [OR], 9.912; 95% confidence interval [CI], 1.790-54.880; and OR, 12.395; 95% CI, 1.187-129.444, respectively) and those who underwent mastectomy (OR, 6.805; 95% CI, 1.800-25.733; and OR, 9.645; 95% CI, 2.075-44.829, respectively) or mastectomy with reconstruction (OR, 13.122; 95% CI, 2.488-69.218; and OR, 20.075; 95% CI, 2.873-140.261, respectively). Adhesive capsulitis of the shoulder is a common problem after breast cancer treatment. An age of 50-59years and mastectomy are major risk factors for adhesive capsulitis, and breast reconstruction additionally increases the risk. Patients with these risk factors require greater attention for early diagnosis and proper treatment.

Diabetes mellitus and accompanying hyperlipidemia are independent risk factors for adhesive capsulitis: a nationwide population-based cohort study (version 2)

Previous case-control studies of Caucasian ethnicity have reported the association of adhesive capsulitis (AC) with diabetes mellitus (DM). To further investigate the risk of AC in subjects with DM in an Asian population, we performed the present cohort study featured the analyses of a randomly selected sub-dataset of one million individuals insured by the Taiwan National Health Insurance for the period spanning 1996-2008. The study and comparison cohorts consisted of 5,109 newly diagnosed diabetic patients and 20,473 randomly selected non-diabetic subjects aged ≥ 20 years in the year 2000. Both cohorts were followed up until December 2008 to measure AC incidence. We found that the incidence density of AC in the DM cohort was 3.08 times that of the comparison cohort (146.9 vs. 47.7 per 10,000 person-years), and rate ratios varied from 1.23 to 4.98 by categorized sociodemographic factors and comorbidity. The hazard ratio (HR) of AC for DM subjects remained significantly higher than that for non-DM subjects (p < 0.001) in all models. The HR increased in older age-groups (p < 0.001) and females (p < 0.001). Hyperlipidemia consistently increases the risk of AC in both univariate (HR = 2.67, 95% confidence interval (CI) 2.36-4.06) and multivariate analyses (HR = 1.29, 95% CI 1.11-1.49). In this eight-year study period, we found that DM and accompanying hyperlipidemia were independent risk factors for AC. The risks are higher for older-aged women. Findings in the present study help to identify high-risk patient groups to exercise early prevention of AC and enhance comprehensive care quality of DM subjects.

Secular trend of adhesive capsulitis

Adhesive capsulitis (AC) is a painful shoulder disorder resulting in restrictions of daily activities. Given the recent increase in risk factors for AC, such as diabetes mellitus, research is needed to examine if the incidence of AC has also increased. Therefore, the purpose of this study was to describe the secular trend of AC. Subjects were from The Health Improvement Network, an electronic medical record database of general practices across the UK from 1995-2008. General practitioners diagnosed AC. We included subjects ages 40-79 years and defined an incident case as the first diagnosis of AC following at least 1 year of enrollment in the database. We examined the potential independent effects of age, calendar time, and birth cohort using an age-period-cohort model. To approximate effect estimates, we applied proportional hazards models and separately adjusted for diabetes mellitus. Of 2,188,958 subjects (50.0% women), the incidence of AC was 2.36 and 3.38 per 1,000 person-years for men and women, respectively. Age-period-cohort model graphs suggested a secular trend due to a birth cohort, but not calendar effect. For each 10-year increment in birth cohort, the incidence rate increased by 8% in women (hazard ratio 1.08, 95% confidence interval 1.05-1.13). There was no increase in AC incidence for men. Adjusting for diabetes mellitus did not change these associations materially. We found women born more recently are at a higher risk of developing AC compared with women born earlier. Future research is needed to identify risk factors that may be responsible for this increase.

A Prospective Study of Adhesive Capsulitis of the Shoulder (‘Frozen Shoulder’)in a High Risk Population

In order to evaluate risk factors for adhesive capsulitis of the shoulder ("frozen shoulder') a prospective study was carried out in neurosurgical patients, in whom there is a high incidence of capsulitis. Ninety-nine patients were admitted into the study, most of whom had surgical treatment for sub-arachnoid haemorrhage. Ninety-one patients (92 per cent) were followed up at six months, and of these 23 (25.3 per cent) had developed adhesive capsulitis, which was bilateral in three. Three patients developed the shoulder-hand syndrome. By comparing the patients with capsulitis at six months with those in whom no capsulitis was found, we were able to evaluate 28 possible risk factors (Appendix I). The subsequent development of adhesive capsulitis in our patients was associated with, (1) impairment of consciousness, (2) hemiparesis, (3) duration of post-operative intravenous infusion, (4) age, and (5) depressive personality. These five associations were statistically significant. Associations with phenobarbitine therapy and hysterical personality were suggested, but these did not reach statistical significance. Routine treatment with corticosteroids post-operatively did not prevent capsulitis.