Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial.

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

Five hundred three patients with unilateral primary frozen shoulder were randomized to receive manipulation under anaesthesia with steroid injection (n=201), arthroscopic capsular release with or without steroid injection (n=203), or early structured physiotherapy with steroid injection (n=99). The primary outcome was the Oxford Shoulder Score (OSS) at 12 months. Secondary outcomes included the QuickDASH, pain intensity (Numeric Rating Scale), perceived extent of recovery, and quality of life (EQ-5D-5L). Outcomes were assessed at baseline, 3, 6, and 12 months. Overall, the results revealed that all three treatments resulted in substantial improvements in OSS, but none were clinically superior. Arthroscopic capsular release had slightly higher OSS at 12 months but also more adverse events and higher costs. Manipulation under anaesthesia was the most cost-effective. These findings suggest that less invasive options like manipulation or physiotherapy can be considered first-line, with surgical options reserved for refractory cases.