Revista de Medicina Desportiva (English) July 2018 - Page 20
patients had mobile and painless
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.
18 july 2018 www.revdesportiva.pt
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
2. Büttner-Janz K, Guyer RD, Ohnmeiss DD. Indications
for Lumbar Total Disc Replacement: Selecting the
Right Patient with the Right Indication for the Right
Total Disc. International Journal of Spine Surgery.
3. Siepe CJ, Wiechert K, Khattab MF, Korge A, Mayer
HM. Total lumbar disc replacement in athletes: clinical
results, return to sport and athletic performance. Euro-
pean Spine Journal. 2007;16(7):1001-1013.
4. 4 – Huang RC, Lim MR, Girardi FP, Cammisa FP., Jr
The prevalence of contraindications to total disc replace-
ment in a cohort of lumbar surgical patients. Spine.
5. Tumialán LM, Ponton RP, Garvin A, Gluf WM.
Arthroplasty in the military: a preliminary experience
with ProDisc-C and ProDisc-L. Neurosurg Focus. 2010
6. Blumenthal S, McAfee PC, Guyer RD, Hochschu-
ler SH, Geisler FH, Holt RT, Garcia R Jr, Regan JJ,
Ohnmeiss DD (2005) A prospective, randomized,
multicenter Food and Drug Administration investiga-
tional device exemptions study of lumbar total disc
replacement with the CHARITE artificial disc versus
lumbar fusion: part I: evaluation of clinical outcomes.
Spine 30:1565–1575; discussion E1387–E1591.
7. Delamarter RB, Fribourg DM, Kanim LE, Bae H.
ProDisc artificial total lumbar disc replacement: intro-
duction and early results from the United States clinical
trial. Spine. 2003;28:S167–S175.
8. Zigler JE. Clinical results with ProDisc: European expe-
rience and U.S. investigation device exemption study.
9. Cinotti G, David T, Postacchini F. Results of disc
prosthesis after a minimum follow-up period of 2 years.
10. Guyer RD, Ohnmeiss DD. Intervertebral disc prosthe-
ses. Spine. 2003;28:S15–S23.
11. Gao F, Mao T, Sun W, Guo W, Wang Y, Li Z, Abhinav
P. An Updated Meta-Analysis Comparing Artificial
Cervical Disc Arthroplasty (CDA) Versus Anterior Cer-
vical Discectomy and Fusion (ACDF) for the Treatment
of Cervical Degenerative Disc Disease (CDDD). Spine
(Phila Pa 1976). 2015 Dec;40(23):1816-23.
12. Luo J, Huang S, Gong M, Dai X, Gao M, Yu T, Zhou
Z, Zou X. Comparison of artificial cervical arthroplasty
versus anterior cervical discectomy and fusion for one-
-level cervical degenerative disc disease: a meta-analy-
sis of randomized controlled trials. Eur J Orthop Surg
Traumatol (2015) 25 (Suppl 1):S115–S125.
13. Buckland AJ, Baker JF, Roach RP, Spivak JM. Cervical
disc replacement – emerging equivalency to anterior
cervical discectomy and fusion. Int Orthop. 2016
14. Alvin MD, Mroz TE. The Mobi-C cervical disc for one-
-level and two-level cervical disc replacement: a review
of the literature. Medical Devices (Auckland, NZ).
15. Ren C, Song Y, Xue Y, Yang X. Mid – to long-term out-
comes after cervical disc arthroplasty compared with
anterior discectomy and fusion: a systematic review
and meta-analysis of randomized controlled trials. Eur
Spine J. 2014 23:1115–1123.
16. Bertagnoli R, Yue JJ, Kershaw T, Shah RV, Pfeiffer
F, Fenk Mayer A, et al. Lumbar total disc arthro-
plasty utilizing the ProDisc prosthesis in smokers
versus nonsmokers: a prospective study with 2-year
minimum follow-up. Spine (Phi la Pa 1976). 2006 Apr
17. Bertagnoli R, Yue JJ, Pfeiffer F, Fenk-Mayer A,
Lawrence JP, Kershaw T, et al. Early results after
ProDisc-C cervical disc replacement. J Neurosurg
Spine. 2005 Apr;2(4):403-10.
18. Chung SS, Lee CS, Kang CS. Lumbar total disc
replacement using ProDisc II: a prospective study with
a 2-year minimum follow-up. J Spinal Disord Tech.
19. Guyer RD, McAfee PC, Hochschuler SH, Blumen-
thal SL, Fedder IL, Ohnmeiss DD, Cunningham BW.
Prospective randomized study of the Charite artificial
disc: data from two investigational centers. Spine J.
2004 Nov-Dec;4(6 Suppl):252S-259S.
20. Mummaneni PV, Burkus JK, Haid RW, Traynelis VC,
Zdeblick TA. Clinical and radiographic analysis of cer-
vical disc arthroplasty compared with allograft fusion:
a randomized controlled clinical trial. J Neurosurg
Spine. 2007 Mar;6(3):198-209.
21. Murrey D, Janssen M, Delamarter R, Goldstein
J, Zigler J, Tay B, et al. Results of the prospective,
randomized, controlled multicenter Food and Drug
Administration investigational device exemption
study of the ProDisc-C total disc replacement versus
anterior discectomy and fusion for the treatment of
1-level symptomatic cervical disc disease. Spine J. 2009
22. Sasso RC, Smucker JD, Hacker RJ, Heller JG: Artifi-
cial disc versus fusion: a prospective, randomized study
with 2-year follow-up on 99 patients. Spine (Phila
Pa 1976). 2007 Dec 15;32(26):2933-40; discussion
23. Zigler J, Delamarter R, Spivak JM, Linovitz RJ,
Danielson GO III, Haider TT, et al. Results of the
prospective, randomized, multicenter Food and Drug
Administration investigational device exemption
study of the ProDisc-L total disc replacement versus
circumferential fusion for the treatment of 1-level
degenerative disc disease. Spine (Phila Pa 1976). 2007
May 15;32(11):1155-62; discussion 1163.
24. Guyer RD, McAfee PC, Banco RJ, Bitan FD,
Cappuccino A, Geisler FH, Hochschuler SH, et al.
Prospective, randomized, multicenter Food and Drug
Administration investigational device exemption study
of lumbar total disc replacement with the CHARITE
artificial disc versus lumbar fusion: five-year follow-up.
Spine J. 2009 May;9(5):374-86.
25. McAfee PC, Cunningham B, Holsapple G, Adams
K, Blumenthal S, Guyer RD, Dmietriev A, Maxwell
JH, Regan JJ, Isaza J. A prospective, randomized,
multicenter Food and Drug Administration investi-
gational device exemption study of lumbar total disc
replacement with the CHARITE artificial disc versus
lumbar fusion: part II: evaluation of radiographic
outcomes and correlation of surgical technique accuracy
with clinical outcomes. Spine (Phila Pa 1976). 2005 Jul
15;30(14):1576-83; discussion E388-90.
26. Sasso RC, Smucker JD, Hacker RJ, Heller JG. Clinical
outcomes of BRYAN cervical disc arthroplasty: a
prospective, randomized, controlled, multicenter trial
with 24-month follow-up. J Spinal Disord Tech. 2007
27. Cunningham BW, McAfee PC, Geisler FH, Holsap-
ple G, Adams K, Blumenthal SL, et al. Distribution
of in vivo and in vitro range of motion following 1-level
arthroplasty with the CHARITE artificial disc compared
with fusion. J Neurosurg Spine. 2008 Jan;8(1):7-12.
28. Hilibrand AS, Robbins M. Adjacent segment degene-
ration and adjacent segment disease: the consequen-
ces of spinal fusion? Spine J. 2004 Nov-Dec;4(6
29. McCormick PC. The adjacent segment. J Neurosurg
Spine. 2007 Jan;6(1):1-4; discussion 4.
30. Boselie TF, Willems PC, van Mameren H, de
Bie R, Benzel EC, van Santbrink H. Arthroplasty
versus fusion in single-level cervical degenerative disc
disease. Cochrane Database Syst Rev. 2012 Sep
31. Fransen P, Schils F. Résultats à long terme de
l’arthroplastie cervicale par prothèse de disque Revue de
la littérature. Rev Med Liege 2014, 69(7-8),428-433.
32. Jacobs WC, van der Gaag NA, Kruyt MC, Tuschel A,
de Kleuver M, Peul WC, Verbout AJ, Oner FC. Total
disc replacement for chronic discogenic low back pain:
a Cochrane review. Spine (Phila Pa 1976). 2013 Jan
34. Healy WL, Sharma S, Schwartz B, Iorio R. Athletic
activity after total joint arthroplasty. J Bone Joint Surg
Am. 2008 Oct;90(10):2245-52.
35. Kuster MS. Exercise recommendations after total joint
replacement: a review of the current literature and
proposal of scientifically based guidelines. Sports Med.
36. Moura D, Figueiredo A, Reis e Reis A, Fonseca F.
Prática Desportiva e Artroplastias da Anca, Joelho e
Ombro. Rev. Medicina Desportiva informa, 2016.
37. Laupacis A, Bourne R, Rorabeck C, Feeny D, Wong
C, Tugwell P, Leslie K, Bullas R. The effect of elective
total hip replacement on health-related quality of life. J
Bone Joint Surg Am. 1993;75:1619-26.
38. McGrory BJ, Stuart MJ, Sim FH. Participation in sports
after hip and knee arthroplasty: review of literature
and survey of surgeon preferences. Mayo Clin Proc.
39. Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts
S, Cook KF, Gordon MJ, Mathis KB. What functional
activities are important to patients with knee replace-
ments? Clin Orthop Relat Res. 2002;404:172-88.
40. Dauty M, Letenneur J. Sports participation after
joint arthroplasty. Ann Readapt Med Phys. 2007
41. Kilgus DJ, Dorey FJ, Finerman GA, Amstutz HA.
Patient activity, sport participation and impact loading
on the durability of cemented total hip replacements.
Clin. Orth. 1991; 269: 25–31.
42. Vogel LA, Carotenuto G, Basti JJ, Levine WN.
Physical activity after total joint arthroplasty. Sports
Health. 2011 Sep;3(5):441-50.
43. Healy WL, Iorio R, Lemos MJ. Athletic activity after
joint replacement. Am J Sports Med. 2001 May-
44. Ledet EH, Sachs BL, Brunski JB, Gatto CE, Donzelli
PS. Real-time in vivo loading in the lumbar spine:
part 1. Interbody implant: load cell design and
preliminary results. Spine (Phila Pa 1976). 2000 Oct
45. Wilke H, Neef P, Hinz B, Seidel H, Claes L. Intradis-
cal pressure together with anthropometric data a dat a
set for the validation of models. Clin Biomech (Bristol,
Avon). 2001;16 Suppl 1:S111-26.
46. McAfee PC. The indications for lumbar and cervical
disc replacement. Spine J. 2004 Nov-Dec;4(6
47. Singh K, Vaccaro AR, Albert TJ. Assessing the poten-
tial impact of total disc arthroplasty on surgeon practice
patterns in North America. Spine J 4 (6 Suppl):195S–
48. Tropiano P, Huang RC, Girardi FP, Cammisa FP, Jr,
Marnay T. Lumbar total disc replacement. Seven to
eleven-year follow-up. J Bone Joint Surg Am. 2005;87-
49. German Society of Neurosurgery. Cervical spine –
sports performance despite artificial disc. Sportverletz
Sportschaden. 2012 Sep;26(3):140.
50. Bauman S, Williams D, Petruccelli D, Elliott W, de
Beer J. Physical activity after total joint replacement:
a cross-sectional survey. Clin J Sport Med. 2007
51. Clifford PE, Mallon WJ. Sports after total joint replace-
ment. Clin Sports Med. 2005 Jan;24(1):175-86.