Abstract / Summary
Frozen shoulder (FS) and Dupuytren’s disease (DD) are fibroproliferative conditions that share risk factors, genetic susceptibility, and biological pathways, including dysregulation of collagen deposition and WNT signalling. While co-occurrence has been described, the temporal relationship between FS and subsequent DD remains unclear. We conducted a retrospective cohort study using the Merative™ MarketScan ® Commercial Database (2007–2023). Adults aged 40–65 years with incident FS were identified and propensity score–matched 1:1 to individuals without FS on demographics, comorbidities, and healthcare utilization. The primary outcome was incident DD. Cox proportional hazards models with robust variance estimation were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Interaction analyses assessed effect modification by age and diabetes, and sensitivity analyses included landmark analyses and restricted follow-up duration. The matched cohort included 208,261 pairs. During follow-up, 1,896 DD events occurred in the FS group compared with 453 in controls. FS was associated with an increased risk of subsequent DD (HR 2.56 95% CI, 2.30–2.83). A significant age interaction was observed, with stronger associations in younger FS individuals (HR 3.29 for ages 40–49 vs. 1.84 for 60–65 years). No significant interaction with diabetes was found. Results remained consistent in both men and women and in sensitivity analyses restricted to ≥ 24 and ≥ 48 months of follow-up and landmark analyses at 6 and 12 months. FS is associated with an increased risk of subsequent DD. These findings support the concept that FS may represent an early manifestation of a systemic fibroproliferative diathesis, particularly in younger individuals, and may serve as a clinical marker of future fibrotic disease risk. Not applicable.