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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 7, 928-932.
doi: 10.1302/0301-620X.89B7.19097  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The pathology of frozen shoulder

G. C. R. Hand, FRCS(Trauma & Orth), Fellow in Shoulder and Elbow Surgery1; N. A. Athanasou, Professor of Pathology1; T. Matthews, MBBS, BSc, FRCS(Eng), Henry Smith Research Fellow1; and A. J. Carr, ChM, FRCS, Nuffield Professor of Orthopaedic Surgery2

1 Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
2 University of Oxford, Wellington Square, Oxford, OX1 2JD, UK.

Correspondence should be sent to Mr G. C. R. Hand at Southampton University Hospitals Trust, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; e-mail: mail{at}campbellhand.com

We treated 22 patients with a diagnosis of primary frozen shoulder resistant to conservative treatment by manipulation under anaesthetic and arthroscopic release of the rotator interval, at a mean time from onset of 15 months (3 to 36). Biopsies were taken from this site and histological and immunocytochemical analysis was performed to identify the types of cell present. The tissue was characterised by the presence of fibroblasts, proliferating fibroblasts and chronic inflammatory cells. The infiltrate of chronic inflammatory cells was predominantly made up of mast cells, with T cells, B cells and macrophages also present.

The pathology of frozen shoulder includes a chronic inflammatory response with fibroblastic proliferation which may be immunomodulated.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General