FREECAP

What is a frozen shoulder?

Frozen shoulder is a common joint disease affecting 10% of the working population. The condition causes significant shoulder pain, disability and social isolation and predominantly affects patients between 40-60 years old.

Frozen shoulder is poorly understood and currently there are no effective treatments.  The joint capsule, an envelope surrounding the shoulder joint becomes inflamed and thickened, causing severe stiffness, which significantly impacts day-to-day life. 

Patients typically have symptoms for several years, yet interestingly the condition is self-limiting: it almost always resolves during this time.  In contrast many other forms of inflammatory joint disease including arthritis never resolve. Therefore, frozen shoulder is a unique condition whereby chronic inflammation and thickening of the shoulder joint capsule spontaneously resolves over time, as shown in the figure below. 

Animal models of frozen shoulder do not accurately represent the condition affecting patients. Access to patient tissue is vital to advance our understanding of disease. In 2020, we established an ethically approved national clinical study called ‘ICECAP’ to collect tissue from the joint capsule of patients undergoing shoulder surgery for advanced stage frozen shoulder. Findings from this study have identified distinct populations of cells in the shoulder joint capsule have become enriched in order to resolve inflammation and fibrosis.

Understanding Inflammatory Fibrosis in Early Adhesive Capsulitis.

Having identified the biological processes that bring about resolution of disease in advanced-stage frozen shoulder, the focus of this project is to improve understanding of the underlying biological processes occurring in patients with early-stage Frozen Shoulder.

The project will involve collecting a small sample of the capsule which surrounds the shoulder joint from patients who are undergoing planned hydrodilatation of the shoulder capsule as part of their routine clinical care pathway. This tissue will then be studied using cutting edge laboratory techniques to further our understanding of the inflammatory and resolution processes in early stage disease.

Our findings will help to identify more targeted and disease-stage specific treatments for patients suffering from frozen shoulder.

Male and female patients aged between 18-65 years of age are eligible for inclusion to the study. We plan to collect tissues from 20 frozen shoulder patients undergoing planned ultrasound guided hydrodilatation of the shoulder capsule. Patients with shoulder osteoarthritis or disease affecting joints including Rheumatoid Arthritis cannot be included into this study. 

Meet the team