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Review
. 2017 Dec 11;5(4):217-223.
doi: 10.1055/s-0037-1608951. eCollection 2017 Dec.

Risk Factors for Shoulder Stiffness: Current Concepts

Davide Cucchi  1   2 , Antongiulio Marmotti  3 , Silvana De Giorgi  4 , Alberto Costa  5 , Rocco D'Apolito  6 , Marco Conca  7 , Alessandro Russo  8 , Maristella F Saccomanno  9 , Laura de Girolamo  10 ; SIGASCOT Research Committee
Affiliations
Review

Risk Factors for Shoulder Stiffness: Current Concepts

Davide Cucchi et al. Joints. .

Abstract

Shoulder stiffness is a condition of painful restriction of the glenohumeral range of motion. Numerous risk factors for primary and postoperative shoulder stiffness have been described. This article summarizes the known aspects of the pathophysiology of shoulder stiffness, with special attention to elements of molecular biology and genetics, which could influence the risk of developing shoulder stiffness. Furthermore, the role of hormonal and metabolic factors, medical disorders, drugs, and of other published risk factors for primary and postoperative shoulder stiffness is reviewed and discussed. Finally, aspects related to shoulder surgery and postoperative rehabilitation protocols, which could influence the development of postoperative stiffness are presented.

Keywords: adhesive capsulitis; frozen shoulder; inflammation; shoulder arthroscopy; shoulder stiffness.

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Conflict of interest statement

Conflict of Interest Dr de Girolamo reports personal fees from Lipogems and Geistlich and grants from IGEA, outside the submitted work. All the other authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Key elements of the inflammatory-fibrotic cascade underlying shoulder stiffness (SS), which may allow to hypothesize an underlying metabolic/pro-inflammatory systemic condition, characterized by TNF-α/TGF-β hyperexpression. Abbreviations: HGF: hepatocyte growth factor; IL: interleukin; MMP: matrix metalloproteinases; PDGF: platelet-derived growth factor; TGF-β: transforming growth factor-β; TIMP, tissue inhibitors of metalloproteinases; TNF-α: tumor necrosis factor-α.
See this image and copyright information in PMC

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