Revista de Medicina Desportiva (English) July 2018 - Page 20

patients had mobile and painless cervical spine. Currently, there is not enough sci- entific evidence regarding the type and level of intensity for sports prac- tice that should be recommended or avoided after disc arthroplasty in order not to affect the artificial joint survival. 5 None of the existing stud- ies have sufficient follow-up time to be able to conclude about the effects of the physical exercise on the disc prostheses. The goal is to find a balance that guarantees the ben- efits of physical activity, while not significantly affecting the duration of arthroplasty. 34,36 Current general recommendations The current absence of randomized prospective large studies regarding the assessment of discs arthroplasties survival leads to the actual decision about sports practice in these patients is only based on experts opinion, with a low level of scientific evidence. 3,34 The key is to analyze case by case, to discuss preoperatively the patient’s goals and expectations and to have proper surgical and rehabilitation treatments that enable them to adjust them to the final results. 35,38,50,51 Patients should be encouraged to remain physically active, but those who wish to play high-impact, contact or high-level competition sports should be informed about and understand the risks theoretically associated with this practice, specially about migration and implant wear, with consequent need of an early revi- sion surgery. The decision to practise a particular sport must belong to the patient, after well informed weighting about risks and benefits. 34,38,42,43,50 In addition, these patients must have a frequent clinical-radiological control of their disc arthroplasty in order to detect and to act early over the complications that may arise. 38 There is a need for long-term, multi-centric prospective studies with a greater number of patients, in order to be able to identify the risks of physical activ- ity on the disc prosthesis. 3 The authors declare that there is no con- flict of interest. Correspondence 18 july 2018 Bibliography 1. Auerbach JD, Anakwenze OA, Milby AH, Lonner BS, Balderston RA. Segmental contribution toward total cervical range of motion: a comparison of cervical disc arthroplasty and fusion. Spine (Phila Pa 1976). 2011 Dec 1;36(25):E1593-9. 2. Büttner-Janz K, Guyer RD, Ohnmeiss DD. 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