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17 pages, 4769 KiB

Open AccessReview

by Ismael Coifman, Ulrich H. Brunner and Markus Scheibel

J. Clin. Med. 2022, 11(7), 2019; https://doi.org/10.3390/jcm11072019 - 4 Apr 2022

Cited by 8 | Viewed by 4849

Glenohumeral osteoarthrosis (OA) may develop after primary, recurrent shoulder dislocation or instability surgery. The incidence is reported from 12 to 62%, depending on different risk factors. The risk of severe OA of the shoulder following dislocation is 10 to 20 times greater than the average population. Risk factors include the patient’s age at the first episode of instability or instability surgery, bony lesions, and rotator cuff tears. For mild stages of OA, arthroscopic removal of intraarticular material, arthroscopic debridement, or arthroscopic arthrolysis of an internal rotation contracture might be sufficient. For severe stages, mobilization of the internal rotation contracture and arthroplasty is indicated. With an intact rotator cuff and without a bone graft, results for anatomical shoulder arthroplasty are comparable to those following primary OA. With a bone graft at the glenoidal side, the risk for implant loosening is ten times greater. For the functional outcome, the quality of the rotator cuff is more predictive than the type of the previous surgery or the preoperative external rotation contracture. Reverse shoulder arthroplasty could be justified due to the higher rate of complications and revisions of non-constrained anatomic shoulder arthroplasties reported. Satisfactory clinical and radiological results have been published with mid to long term data now available. Full article

(This article belongs to the Special Issue Shoulder Arthroplasty: State of the Art and Future Perspectives)

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7 pages, 242 KiB

Open AccessArticle

Intra-Articular Laser Treatment Plus Platelet Rich Plasma (PRP) Significantly Reduces Pain in Many Patients Who Had Failed Prior PRP Treatment

by Chadwick C. Prodromos, Susan Finkle, Alexander Dawes and Angelo Dizon

Medicines 2019, 6(3), 75; https://doi.org/10.3390/medicines6030075 - 16 Jul 2019

Cited by 6 | Viewed by 4641

Abstract

Background: In our practice, Platelet Rich Plasma (PRP) injections effectively reduce pain in most, but not all, arthritic patients. When PRP treatment fails, joint replacement surgery is often the only good alternative. Surface Low-Level-Laser-Therapy (LLLT) has not been helpful for osteoarthrosis in our experience. We hypothesized that intra-articular laser (IAL) treatment combined with PRP would improve results in patients with prior ineffective PRP treatment. Methods: We offered Intra-articular Low-Level-Laser-Therapy (IAL) treatment simultaneously with repeat PRP injection to patients who had received no benefit from PRP alone. They were the treatment and also historical control group since all had failed PRP treatment alone. Thirty joints were treated: 22 knees, 4 hips, 2 shoulder glenohumeral joints and 2 first carpo-metacarpal (1st CMC). Results: No adverse events were seen at any time after treatment in any patient. Twenty-eight joints were available for re-evaluation: ≥ 40% improvement was seen in 46% (6 months), 32% (12 months) and 32% (24 months) post-treatment. Mean SANE scores improved significantly at 1 and 2 years. Thirteen patients failed treatment and had joint replacement. Conclusions: PRP with IAL allowed avoidance of surgery and good pain control at least two years post-treatment in nearly half of patients who had failed PRP treatment alone. Full article

(This article belongs to the Special Issue Innovative Laser Medicine and Traditional Acupuncture Therapy)

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