Fig. 1.

The schematic diagrams of this study. A, B In the clinical setting, it was observed that the majority of frozen shoulder (FS) patients were women who had reached post-menopause (Post-M). Additionally, further investigation, including VAS (Visual Analog Scale) and ASES (American Shoulder and Elbow Surgeon) scores revealed that post-menopausal women tended to experience more severe symptoms. Considering the existing research, there is a strong association between post-menopausal women and osteoporosis (OP). The detailed patient baseline information was listed in Supplementary Table 1. Based on this observation, it was hypothesized that FS and OP might share common underlying mechanisms. C At first, the frozen shoulder (FS) dataset (GSE238053) that we uploaded before and osteoporosis (OP) dataset (GSE56815) were chosen to screen the crosstalk genes linking FS and OP. The p38 MAPK signaling pathway was screening out and the therapeutic effect was verified in vivo. In vitro, totally 36 SD rats were used in this study. First, 6 SD rats were sacrificed to harvest BMDMs. 15 SD rats received bilateral ovariectomy (OVX) and the other 15 SD rats received shame surgery (CON) simultaneously, Secondly, 3 OVX SD rats and 3 CON SD rats were sacrificed at 12 weeks after surgery to get the micro-CT scanning of femurs. The osteoporosis model was constructed successfully. Finally, we euthanized all residual SD rats to complete the ROM, micro-CT, X-ray test and the histological analysis