A high level of scientific evidence is available to guide treatment of primary shoulder stiffness: The SIAGASCOT consensus

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 32; no. 1; pp. 37 - 46
• Main Authors: Cucchi, Davide, Di Giacomo, Giovanni, Compagnoni, Riccardo, Castricini, Roberto, Formigoni, Chiara, Radici, Mattia, Melis, Barbara, Brindisino, Fabrizio, De Giorgi, Silvana, De Vita, Andrea, Lisai, Andrea, Mangiavini, Laura, Candela, Vincenzo, Carrozzo, Alessandro, Pannone, Antonello, Menon, Alessandra, Giudici, Luca Dei, Klumpp, Raymond, Padua, Roberto, Carnevale, Arianna, Rosa, Francesco, Marmotti, Antongiulio, Peretti, Giuseppe M., Berruto, Massimo, Milano, Giuseppe, Randelli, Pietro, Bonaspetti, Giovanni, De Girolamo, Laura
• Format: Journal Article
• Language: English
• Published: Germany 01-01-2024
• Subjects: adhesive capsulitis; Consensus; evidence; frozen shoulder; Humans; Joint Diseases; Physical Therapy Modalities; Shoulder; shoulder stiffness; Upper Extremity; consensus; adhesive capsulitis; evidence; frozen shoulder; shoulder stiffness
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1002/ksa.12017

Purpose
Shoulder stiffness (SS) is a condition characterised by active and passive restricted glenohumeral range of motion, which can occur spontaneously in an idiopathic manner or be associated with a known underlying aetiology. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. Herein we present the results of a national consensus on the treatment of primary SS.
Methods
The project followed the modified Delphi consensus process, involving a steering, a rating and a peer‐review group. Sixteen questions were generated and subsequently answered by the steering group after a thorough literature search. A rating group composed by professionals specialised in the diagnosis and treatment of shoulder pathologies rated the question–answer sets according to the scientific evidence and their clinical experience.
Results
Recommendations were rated with an average of 8.4 points out of maximum 9 points. None of the 16 answers received a rating of less than 8 and all the answers were considered as appropriate. The majority of responses were assessed as Grade A, signifying a substantial availability of scientific evidence to guide treatment and support recommendations encompassing diagnostics, physiotherapy, electrophysical agents, oral and injective medical therapies, as well as surgical interventions for primary SS.
Conclusions
A consensus regarding the conservative and surgical treatment of primary SS could be achieved at a national level. This consensus sets basis for evidence‐based clinical practice in the management of primary SS and can serve as a model for similar initiatives and adaptable guidelines in other European countries and potentially on a global scale.
Level of Evidence: Level I.