{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T22:29:42Z","timestamp":1781216982056,"version":"3.54.1"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The project followed the modified Delphi consensus process, involving a steering, a rating and a peer\u2010review 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\u2013answer sets according to the scientific evidence and their clinical experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A consensus regarding the conservative and surgical treatment of primary SS could be achieved at a national level. This consensus sets basis for evidence\u2010based 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.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> Level I.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12017","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T12:39:26Z","timestamp":1704976766000},"page":"37-46","source":"Crossref","is-referenced-by-count":13,"title":["A high level of scientific evidence is available to guide treatment of primary shoulder stiffness: The SIAGASCOT consensus"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6284-7977","authenticated-orcid":false,"given":"Davide","family":"Cucchi","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery University of Bonn Bonn Germany"},{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Giacomo","sequence":"additional","affiliation":[{"name":"Concordia Hospital Roma Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Compagnoni","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"U.O.C. 1\u00b0 Clinica Ortopedica ASST G. Pini\u2010CTO Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Castricini","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Casa di Cura Villa Verde Fermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Formigoni","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"GIDIF\u2010RBM\u00a0\u2010\u00a0Italian Group of Information Specialist from Pharmaceutical Company and Biomedical Research Institutes Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Radici","sequence":"additional","affiliation":[{"name":"U.O.C. 1\u00b0 Clinica Ortopedica ASST G. Pini\u2010CTO Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Melis","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Unit\u00e0 di Ortopedia e traumatologia dello sport Casa di cura \u201cPoliclinico Citt\u00e0 di Quartu\u201d Quartu Sant'Elena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8950-8203","authenticated-orcid":false,"given":"Fabrizio","family":"Brindisino","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cVincenzo Tiberio\u201d University of Molise c\/o Cardarelli Hospital, C\/da Tappino Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"De Giorgi","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"Department of Translational Biomedicine and Neuroscience (DiBraiN) University of Bari Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Vita","sequence":"additional","affiliation":[{"name":"Concordia Hospital Roma Rome Italy"},{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lisai","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Unit\u00e0 Funzionale Chirurgia della Spalla Humanitas San Pio X Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mangiavini","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"IRCCS Istituto Ortopedico Galeazzi\u2010Sant'Ambrogio Milan Italy"},{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Candela","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Research Unit of Orthopaedic and Trauma Surgery Fondazione Policlinico Universitario Campus Bio\u2010Medico Rome Italy"},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Carrozzo","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"Department of Orthopaedic Surgery and Traumatology AOU Sant'Andrea, La Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Pannone","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Policlinico \"Citt\u00e0 di Udine\"  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Menon","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"U.O.C. 1\u00b0 Clinica Ortopedica ASST G. Pini\u2010CTO Milan Italy"},{"name":"Laboratory of Applied Biomechanics Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Scuola di Specializzazione in Statistica Sanitaria e Biometria, Dipartimento di Scienze Cliniche e di Comunit\u00e0 Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Dei","family":"Giudici","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cShoulder\u201d Committee Rome Italy"},{"name":"Casa di Cura \"Villa dei Pini\"  Civitanova Marche Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4824-4384","authenticated-orcid":false,"given":"Raymond","family":"Klumpp","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"Department of Orthopaedics and Trauma Surgery ASST Bergamo Ovest Treviglio Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Padua","sequence":"additional","affiliation":[{"name":"Unicamillus Rome, RomaPro Roma Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Carnevale","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"Fondazione Policlinico Universitario Campus Bio\u2010Medico Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Rosa","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cGuidelines\u201d Work\u2010group Rome Italy"},{"name":"Humanitas Clinical and Research Center \u2010IRCCS Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antongiulio","family":"Marmotti","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"Department of Orthopaedics and Traumatology University of Torino Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe M.","family":"Peretti","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Galeazzi\u2010Sant'Ambrogio Milan Italy"},{"name":"Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Berruto","sequence":"additional","affiliation":[{"name":"U.O.C. 1\u00b0 Clinica Ortopedica ASST G. Pini\u2010CTO Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Milano","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties Radiological Sciences, and Public Health, University of Brescia Brescia Italy"},{"name":"ASST Spedali Civili UOC Clinica Ortopedica Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Randelli","sequence":"additional","affiliation":[{"name":"U.O.C. 1\u00b0 Clinica Ortopedica ASST G. Pini\u2010CTO Milan Italy"},{"name":"Laboratory of Applied Biomechanics Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano Milan Italy"},{"name":"Research Center for Adult and Pediatric Rheumatic Diseases (RECAP\u2010RD), Department of Biomedical Sciences for Health Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Bonaspetti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Clinica S. Anna Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"De Girolamo","sequence":"additional","affiliation":[{"name":"SIAGASCOT \u201cBasic Science\u201d Committee Rome Italy"},{"name":"IRCCS Istituto Ortopedico Galeazzi\u2010Sant'Ambrogio Milan Italy"},{"name":"Laboratorio di Biotecnologie applicate all'Ortopedia Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.03.024"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.29581"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1608951"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-021-04979-0"},{"key":"e_1_2_11_6_1","unstructured":"Haute Autorit\u00e9 de Sant\u00e9 (HAS). (2010)Practice guidelines \u201cFormal consensus\u201d method. Rating rules and score analysis. Accessed July 20 2023. Available from:https:\/\/www.has-sante.fr\/"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0853-2128"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1730983"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7183.593"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-023-00664-2"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.15200"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-008-9088-1"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.11152\/mu-2430"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2022.04.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2015.07.025"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011275"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19159715"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2023.2251880"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.03.005"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.23736\/S1973-9087.22.07087-3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211062222"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1333278"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2013.852857"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515616238"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211069577"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.018218"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.06.013"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520956293"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-018-0538-8"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.04.029"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/1274790"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2012.06.015"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009147.pub3"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211018636"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2023.03.032"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.5414\/CP203262"},{"key":"e_1_2_11_37_1","article-title":"Comparison of functional outcome between intra\u2010articular injection of corticosteroid versus platelet\u2010rich plasma in frozen shoulder: a randomized controlled trial","volume":"13","author":"Shahzad H.F.","year":"2021","journal-title":"Cureus"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118217"},{"key":"e_1_2_11_39_1","first-page":"1","article-title":"Effectiveness of hyaluronic acid administration in treating adhesive capsulitis of the shoulder: a systematic review of randomized controlled trials","volume":"2015","author":"Lee L.\u2010C.","year":"2015","journal-title":"BioMed Research International"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2021.07.017"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.5152\/j.aott.2021.21071"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119859277"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007005"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/1457496918772367"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31965-6"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2004.04.004"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jses.2018.11.001"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.01.085"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874325001812010373"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.5397\/cise.2021.00311"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.08.024"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.06.013"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.3233\/BMR-200267"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/17585732221092016"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514523720"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2020.102766"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967115587861"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:08:14Z","timestamp":1760864894000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":56,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/ksa.12017"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12017","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}