{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:14:05Z","timestamp":1783322045797,"version":"3.54.6"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative shoulder stiffness after arthroscopic rotator cuff repair is common and clinically heterogeneous. Established shoulder scores assess pain and function, but do not specifically isolate stiffness during follow-up. The aim of this study was to validate the newly developed Shoulder Stiffness Scale (SSS) as a pragmatic monitoring tool for postoperative shoulder stiffness after arthroscopic rotator cuff repair (ARCR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From a cohort of 973 primary arthroscopic rotator cuff reconstructions, patients without concomitant joint pathology of the same or contralateral arm were included. The new SSS was based on three items related to shoulder pain, subjective and objective ROM ranging from 0 to 10 points. It was collected before surgery, as well as 6 and 12 months postoperatively, along with other pain level parameters, Constant Score (CS), Subjective Shoulder Value (SSV), Oxford Shoulder Score (OSS). Changes of the SSS and its subscales over time, Cronbach's alpha for internal consistency, bottom and ceiling effects were reported. Validity was investigated through SSS associations with other parameters of similar dimension, and functional scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The selected cohort with 740 patients showed postoperative shoulder stiffness in 12.7 %. The SSS averaged 5.1 points (SD 2.5) preoperatively, and decreased significantly to mean 2.9 (SD 2.4) and 1.6 (SD 1.9) at 6 and 12 months, respectively (p&lt;0.001). Cronbach's alpha ranged from 0.612 to 0.740 between time points. The SSS showed significant correlation in all three subscales pain, subjective ROM and objective ROM as well as to the functional scores CS, OSS and SSV scores at baseline, 6 months and 12 months with correlation coefficients ranging from -0.302 (low) to -0.649 (moderate) at baseline and from -0.626 (moderate) to -0.719 (high) at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SSS demonstrated acceptable internal consistency and construct validity as a simple clinician-administered tool for monitoring postoperative shoulder stiffness after ARCR. It complemented existing scores by isolating stiffness as a distinct construct and may facilitate day-to-day clinical follow-up and patient communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06402-4","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:16:30Z","timestamp":1783318590000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The shoulder stiffness scale: a validated tool for monitoring stiffness in arthroscopic rotator cuff reconstructions"],"prefix":"10.1007","volume":"146","author":[{"given":"Samy","family":"Bouaicha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Biner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Selman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Wieser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas Marc","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Audig\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"6402_CR1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1097\/00003086-198710000-00008","volume":"223","author":"RJ Neviaser","year":"1987","unstructured":"Neviaser RJ, Neviaser TJ (1987) The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res 223:59\u201364","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"6402_CR2","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jse.2007.05.009","volume":"17","author":"C Hand","year":"2008","unstructured":"Hand C, Clipsham K, Rees JL, Carr AJ (2008) Long-term outcome of frozen shoulder. J Shoulder Elb Surg 17(2):231\u2013236","journal-title":"J Shoulder Elb Surg"},{"issue":"7530","key":"6402_CR3","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1136\/bmj.331.7530.1453","volume":"331","author":"R Dias","year":"2005","unstructured":"Dias R, Cutts S, Massoud S (2005) Frozen shoulder. BMJ 331(7530):1453\u20131456","journal-title":"BMJ"},{"issue":"4","key":"6402_CR4","doi-asserted-by":"publisher","first-page":"193","DOI":"10.3109\/03009747509165255","volume":"4","author":"B Reeves","year":"1975","unstructured":"Reeves B (1975) The natural history of the frozen shoulder syndrome. Scand J Rheumatol 4(4):193\u2013196","journal-title":"Scand J Rheumatol"},{"issue":"6","key":"6402_CR5","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1097\/SMJ.0b013e3181705d39","volume":"101","author":"CB Tighe","year":"2008","unstructured":"Tighe CB, Oakley WS Jr (2008) The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J 101(6):591\u2013595","journal-title":"South Med J"},{"issue":"2","key":"6402_CR6","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1046\/j.1365-2265.2003.01786.x","volume":"59","author":"M Cakir","year":"2003","unstructured":"Cakir M, Samanci N, Balci N, Balci MK (2003) Musculoskeletal manifestations in patients with thyroid disease. Clin Endocrinol (Oxf) 59(2):162\u2013167","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"6402_CR7","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.jse.2016.04.026","volume":"26","author":"M Schiefer","year":"2017","unstructured":"Schiefer M, Teixeira PFS, Fontenelle C, Carminatti T, Santos DA, Righi LD et al (2017) Prevalence of hypothyroidism in patients with frozen shoulder. J Shoulder Elb Surg 26(1):49\u201355","journal-title":"J Shoulder Elb Surg"},{"issue":"1","key":"6402_CR8","doi-asserted-by":"publisher","first-page":"26","DOI":"10.32098\/mltj.01.2016.04","volume":"6","author":"NH Zreik","year":"2016","unstructured":"Zreik NH, Malik RA, Charalambous CP (2016) Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J 6(1):26\u201334","journal-title":"Muscles Ligaments Tendons J"},{"issue":"3","key":"6402_CR9","first-page":"210","volume":"79","author":"TD Bunker","year":"1997","unstructured":"Bunker TD (1997) Frozen shoulder: unravelling the enigma. Ann R Coll Surg Engl 79(3):210\u2013213","journal-title":"Ann R Coll Surg Engl"},{"issue":"4","key":"6402_CR10","first-page":"e37199","volume":"15","author":"AN Baumann","year":"2023","unstructured":"Baumann AN, Oleson C, Curtis DP, Indermuhle T, Leland JM (2023) 3rd. The Incidence of Postoperative Shoulder Stiffness After Arthroscopic Rotator Cuff Repair: A Systematic Review. Cureus 15(4):e37199","journal-title":"Cureus"},{"issue":"8","key":"6402_CR11","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1016\/j.jse.2018.04.004","volume":"27","author":"K Kingston","year":"2018","unstructured":"Kingston K, Curry EJ, Galvin JW, Li X (2018) Shoulder adhesive capsulitis: epidemiology and predictors of surgery. J Shoulder Elb Surg 27(8):1437\u20131443","journal-title":"J Shoulder Elb Surg"},{"issue":"6","key":"6402_CR12","doi-asserted-by":"publisher","first-page":"232596711558786","DOI":"10.1177\/2325967115587861","volume":"3","author":"L Audig\u00e9","year":"2015","unstructured":"Audig\u00e9 L, Blum R, M\u00fcller AM, Flury M, Durchholz H (2015) Complications Following Arthroscopic Rotator Cuff Tear Repair: A Systematic Review of Terms and Definitions With Focus on Shoulder Stiffness. Orthop J Sports Med 3(6):2325967115587861","journal-title":"Orthop J Sports Med"},{"issue":"1","key":"6402_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1302\/0301-620X.94B1.27093","volume":"94","author":"CM Robinson","year":"2012","unstructured":"Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR (2012) Frozen shoulder. J Bone Joint Surg Br 94(1):1\u20139","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"6402_CR14","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1002\/art.1790040403","volume":"4","author":"KE Roach","year":"1991","unstructured":"Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y (1991) Development of a shoulder pain and disability index. Arthritis Care Res 4(4):143\u2013149","journal-title":"Arthritis Care Res"},{"issue":"4","key":"6402_CR15","doi-asserted-by":"publisher","first-page":"e045702","DOI":"10.1136\/bmjopen-2020-045702","volume":"11","author":"L Audig\u00e9","year":"2021","unstructured":"Audig\u00e9 L, Bucher HCC, Aghlmandi S, Stojanov T, Schwappach D, Hunziker S et al (2021) Swiss-wide multicentre evaluation and prediction of core outcomes in arthroscopic rotator cuff repair: protocol for the ARCR_Pred cohort study. BMJ Open 11(4):e045702","journal-title":"BMJ Open"},{"key":"6402_CR16","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1097\/00003086-198701000-00023","volume":"214","author":"CR Constant","year":"1987","unstructured":"Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160\u2013164","journal-title":"Clin Orthop Relat Res"},{"issue":"4","key":"6402_CR17","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1302\/0301-620X.78B4.0780593","volume":"78","author":"J Dawson","year":"1996","unstructured":"Dawson J, Fitzpatrick R, Carr A (1996) Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg Br 78(4):593\u2013600","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"6402_CR18","doi-asserted-by":"publisher","first-page":"505","DOI":"10.2106\/00004623-200004000-00006","volume":"82","author":"C Gerber","year":"2000","unstructured":"Gerber C, Fuchs B, Hodler J (2000) The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 82(4):505\u2013515","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"6402_CR19","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf 42(2):377\u2013381","journal-title":"J Biomed Inf"},{"key":"6402_CR20","doi-asserted-by":"publisher","first-page":"53","DOI":"10.5116\/ijme.4dfb.8dfd","volume":"2","author":"M Tavakol","year":"2011","unstructured":"Tavakol M, Dennick R (2011) Making sense of Cronbach\u2019s alpha. Int J Med Educ 2:53\u201355","journal-title":"Int J Med Educ"},{"issue":"5","key":"6402_CR21","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1007\/s11136-017-1765-4","volume":"27","author":"LB Mokkink","year":"2018","unstructured":"Mokkink LB, de Vet HCW, Prinsen CAC et al (2018) COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Qual Life Res 27(5):1171\u20131179. https:\/\/doi.org\/10.1007\/s11136-017-1765-4","journal-title":"Qual Life Res"},{"issue":"2","key":"6402_CR22","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.jse.2010.07.008","volume":"20","author":"JD Zuckerman","year":"2011","unstructured":"Zuckerman JD, Rokito A (2011) Frozen shoulder: a consensus definition. J Shoulder Elb Surg 20(2):322\u2013325","journal-title":"J Shoulder Elb Surg"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06402-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-026-06402-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06402-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:16:31Z","timestamp":1783318591000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-026-06402-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6402"],"URL":"https:\/\/doi.org\/10.1007\/s00402-026-06402-4","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"12 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"247"}}