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Shoulder Center, Hirslanden Clinique la Colline, Geneva, Switzerland
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The main goal of this study was to determine the rate of return to sport (RTS) after shoulder arthroplasty.
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A systematic review of the literature was performed using the PRISMA guidelines. All clinical studies written in English, French or German, with a level of evidence of 1 to 4, and evaluating return to sport after shoulder arthroplasty, were included.
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A total of 23 studies were included with 2199 patients who underwent hemiarthroplasty (HA), anatomic total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RSA). Mean age was 68 years (range 18 to 92.6), sex ratio (male:female) was 1:1.5. The surgery was performed on the non-dominant/dominant shoulder in 1:1.8 cases. The mean follow-up was 4.2 years. The rate of RTS was 75.5% with a mean time of 7 months. It was 77.4% for TSA, 75% for RSA and 71.2% for HA (P = non-significant).
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RTS after shoulder arthroplasty is high, regardless the type of arthroplasty, with a trend for a higher rate after TSA. Patients who were able to maintain a sport activity preoperatively had a greater chance of RTS after arthroplasty. Failure to RTS seems to be mostly linked to the severity of the underlying condition and length of preoperative disability.
Cite this article: EFORT Open Rev 2021;6:771-778. DOI: 10.1302/2058-5241.6.200147
Faculty of Medicine, University of Geneva, Switzerland
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Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland
Department of Surgical Sciences, Uppsala University, Sweden
Department of Neuroradiology, University Hospital Freiburg, Germany
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Medical Research Department, Artanim Foundation, Geneva, Switzerland
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Shoulder apprehension is related to changes in functional cerebral networks induced by dislocations, peripheral neuromuscular lesions and persistent mechanical glenohumeral instability consisting of micro-motion.
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All the damage to the osseous and soft-tissue stabilizers of the shoulder, as well as neurologic impairment persisting even after stabilization, must be properly identified in order to offer the best possible treatment to the patient.
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There is growing evidence supporting the use of a global multimodal approach, involving, on the one hand, shoulder ‘reafferentation’, including proprioception, mirror therapy and even cognitive behavioural approaches, and, on the other hand, surgical stabilization techniques and traditional physical therapy in order to minimize persistent micro-motion, which may help brain healing. This combined management could improve return to sport and avoid dislocation arthropathy in the long term.
Cite this article: EFORT Open Rev 2018;3:550-557. DOI: 10.1302/2058-5241.3.180007
University of Basel, Basel, Switzerland
Swiss Orthopaedics, Grandvaux, Switzerland
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University of Basel, Basel, Switzerland
Department of Orthopedic Surgery, Division of Shoulder and Elbow, Mayo Clinic, Rochester, Minnesota
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Platelet-rich plasma (PRP) is a revolutionary treatment that harnesses the regenerative power of the body's own platelets to promote healing and tissue regeneration.
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While PRP therapy has emerged as a promising option for augmenting biologic healing in the shoulder, the complexity of shoulder disorders makes it difficult to draw definitive conclusions about the efficacy of PRP across different conditions and stages of disease.
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Our comprehensive review of twenty-four studies highlights the current state of PRP therapy in shoulder pathologies, revealing a wide variety of number of patients, control groups and results. Despite these challenges, the regenerative potential of PRP therapy is moderate in some conditions, with numerous studies demonstrating the positive effects.
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In conclusion, the authors of this study recommend the use of PRP therapy for adhesive capsulitis and rotator cuff repair of medium to large tears. However, they do not recommend the use of PRP for subacromial impingement or rotator cuff tears. It is up to the clinician's discretion to decide whether PRP therapy is appropriate for individual cases. However, there is still insufficient evidence to support the inclusion of PRP therapy in treatment protocols for other shoulder disorders. Therefore, further research is needed to fully explore the potential of PRP therapy in the treatment of various shoulder conditions.