ArticleJournal of experimental orthopaedics2020
The puzzling pathophysiology of frozen shoulders - a scoping review.
Article in Journal of experimental orthopaedics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 39 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effects of Extracorporeal Shock Wave Therapy as a Treatment Intervention for Chronic Adhesive Capsulitis: a Mixed Methods Pilot Study
Hormone Replacement Therapy as an Adjunct Treatment for Adhesive Capsulitis of the Shoulder (Frozen Shoulder) in Peri- and Postmenopausal Women
Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Transarterial Embolization Versus Manipulation Under Anesthesia and Arthroscopic Capsular Release for Refractory Adhesive Capsulitis-A Cost-Effectiveness Analysis.Cardiovascular and interventional radiology · 2026Pooled it
- Joint fibrosis research from a multi-joint perspective: a bibliometric analysis, 2000-2025.Frontiers in surgery · 2026Pooled it
- The diagnostic value of physical examination tests in adhesive capsulitis: a systematic review.European journal of physical and rehabilitation medicine · 2023Pooled it
- Radial shock-wave therapy for frozen shoulder patients with type 2 diabetes mellitus: a pilot trial comparing two different energy levels.European journal of physical and rehabilitation medicine · 2022Trial
- Adhesive capsulitis embolization: a narrative review.Skeletal radiology · 2026Review
- Clinical efficacy and safety of interventional embolization combined with early rehabilitation in the management of post-traumatic shoulder periarthritis.BMC surgery · 2026Article
- From inflammatory activation to fibrotic remodeling: the central role of macrophage heterogeneity in frozen shoulder.Frontiers in immunology · 2026Review
- Signaling pathway networks in frozen shoulder fibrosis: from inflammatory initiation to fibrotic progression.Frontiers in medicine · 2026Review
- Frozen Shoulder as a Systemic Immunometabolic Disorder: The Roles of Estrogen, Thyroid Dysfunction, Endothelial Health, Lifestyle, and Clinical Implications.Journal of clinical medicine · 2025Review
- Efficacy of Combined Intra-articular Steroids and Calcitonin Nasal Spray versus Intra-articular Steroids Alone in the Management of Early Frozen Shoulder: A Prospective Study.Journal of orthopaedic case reports · 2025Article
- Basic Science Research in Frozen Shoulder: Current Updates.Indian journal of orthopaedics · 2025Article
- Efficacy of ozone therapy in the treatment of frozen shoulder in rats: An experimental study.Joint diseases and related surgery · 2025Article
- Clinical efficacy of manipulation under brachial plexus block anesthesia for primary adhesive capsulitis of shoulder: a retrospective cohort study.Frontiers in surgery · 2025Article
- Short-term clinical efficacy of five-step manipulation under anaesthesia combined with arthroscopic shoulder surgery for adhesive capsulitis.Frontiers in surgery · 2025Article
- Relationship Between Metabolic Profile, Pain, and Functionality in Patients with Frozen Shoulder: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- Exploring Metabolic Mechanisms in Calcific Tendinopathy and Shoulder Arthrofibrosis: Insights and Therapeutic Implications.Journal of clinical medicine · 2024Review
- Inferior glenohumeral joint capsule thickness in frozen shoulder via ultrasonography.JSES international · 2024Article
- Rehabilitation in subjects with frozen shoulder: a survey of current (2023) clinical practice of Italian physiotherapists.BMC musculoskeletal disorders · 2024Article
- Risk factors and predictive models for frozen shoulder.Scientific reports · 2024Article
- Psychometric properties of the Disability of Arm Shoulder and Hand (DASH) in subjects with frozen shoulder: a reliability and validity study.BMC musculoskeletal disorders · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
purposeThe 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.
methodsA 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.
resultsOut 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 to an imbalance of extracellular matrix turnover resulting in a stiff and thickened glenohumeral capsule with abundance of type III collagen.
conclusionThis scoping review outlines the complexity of the pathophysiology of frozen shoulder. A comprehensive overview with background information on pathophysiologic mechanisms is given. Leads are provided to progress with research for clinically important prognostic markers and in search for future interventions. LEVEL OF EVIDENCE: Level V.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.