Strategies in Trauma and Limb Reconstruction

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VOLUME 8 , ISSUE 3 ( November, 2013 ) > List of Articles

Original Article

Outcome after modified Putti-Platt procedure for recurrent traumatic anterior shoulder dislocations

Gijs I. T. Iordens, Esther M. M. van Lieshout, Bernd C. Van Es, Niels W. L. Schep, Roelf S. Breederveld, Peter Patka, Dennis Den Hartog

Keywords : Shoulder, Instability, Bankert, Putti-Platt, Procedure

Citation Information : Iordens GI, van Lieshout EM, Van Es BC, Schep NW, Breederveld RS, Patka P, Den Hartog D. Outcome after modified Putti-Platt procedure for recurrent traumatic anterior shoulder dislocations. 2013; 8 (3):141-147.

DOI: 10.1007/s11751-013-0171-x

License: CC BY-NC-SA 4.0

Published Online: 30-11-2013

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Most recent studies on procedures for stabilizing the glenohumeral joint focus on arthroscopic techniques. A relatively simple open procedure is the modified Putti-Platt procedure. The aim of these retrospective case series was to evaluate the functional outcome, patient satisfaction, and quality of life of patients who underwent this procedure. After a median follow-up time of 4.7 (P25–P75 1.7–6.8) years, fifty-one patients could be enrolled with a mean age of 25 (21–39) years. Five patients (10 %) reported re-dislocations. The median Constant score for the affected side was 84 (P25–P75 75–91). Median loss of motion in abduction, elevation, external rotation, and external rotation in 90° of abduction did not exceed 10° when compared to the healthy shoulder. A median Rowe score of 92 (P25–P75 75–95) was measured. The WOSI score and SF-36 showed excellent quality of life. The VAS proved high patient satisfaction with the outcome; 7.9 (6.8–9.5). We concluded that the modified Putti-Platt procedure leads to excellent outcome scores and only marginal restriction in range of motion combined with a high patient satisfaction. Our data prove that excellent results can be obtained with a relatively simple open procedure.


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  1. Hayes K et al (2002) Shoulder instability: management and rehabilitation. J Orthop Sports Phys Ther 32:497-509
  2. Pensak M et al (2010) Management of acute anterior shoulder instability in adolescents. Orthop Nurs 29:237-43; quiz 244-5
  3. Robinson CM et al (2006) Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am 88: 2326-2336
  4. Bottoni CR et al (2006) Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med 34:1730-1737
  5. Fabbriciani C et al (2004) Arthroscopic versus open treatment of Bankart lesion of the shoulder: a prospective randomized study. Arthroscopy 20:456-462
  6. Sperber A et al (2001) Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study. J Shoulder Elbow Surg 10:105-108
  7. Kiss J et al (1998) The results of the Putti-Platt operation with particular reference to arthritis, pain, and limitation of external rotation. J Shoulder Elbow Surg 7:495-500
  8. Osmond-Clarke H (1948) Habitual dislocation of the shoulder; the Putti-Platt operation. J Bone Joint Surg Br 30B:19-25
  9. Salomonsson B et al (2009) The Bankart repair versus the Putti- Platt procedure: a randomized study with WOSI score at 10-year follow-up in 62 patients. Acta Orthop 80:351-356
  10. Gill TJ, Zarins B (2003) Open repairs for the treatment of anterior shoulder instability. Am J Sports Med 31:142-153
  11. van der Zwaag HM et al (1999) Glenohumeral osteoarthrosis after Putti-Platt repair. J Shoulder Elbow Surg 8:252-258
  12. Brav EA, Jeffress VH (1952) Simplified Putti-Platt reconstruction for recurrent shoulder dislocation; a preliminary report. West J Surg Obstet Gynecol 60:93-97
  13. Leach RE, et al (1982) Results of a modified Putti-Platt operation for recurrent shoulder dislocations and subluxations. Clin Orthop Relat Res 164:20-25
  14. Symeonides PP (1972) The significance of the subscapularis muscle in the pathogenesis of recurrent anterior dislocation of the shoulder. J Bone Joint Surg Br 54:476-483
  15. Symeonides PP (1989) Reconsideration of the Putti-Platt procedure and its mode of action in recurrent traumatic anterior dislocation of the shoulder. Clin Orthop Relat Res 246:8-15
  16. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160-164
  17. Beaton DE et al (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther 14:128-146
  18. Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29:602-608
  19. Kocher MS et al (2005) Reliability, validity, and responsiveness of the American shoulder and elbow surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis. J Bone Joint Surg Am 87:2006-2011
  20. Rowe CR, Patel D, Southmayd WW (1978) The Bankart procedure: a long-term end-result study. J Bone Joint Surg Am 60:1-16
  21. Kirkley A et al (1998) The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med 26:764-772
  22. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473-483
  23. Rowe CR, Zarins B (1981) Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am 63:863-872
  24. Ahmad CS et al (2005) Biomechanics of shoulder capsulorrhaphy procedures. J Shoulder Elbow Surg 14:12S-18S
  25. Hawkins RH, Hawkins RJ (1985) Failed anterior reconstruction for shoulder instability. J Bone Joint Surg Br 67:709-714
  26. Shah AS, Karadsheh MS, Sekiya JK (2011) Failure of operative treatment for glenohumeral instability: etiology and management. Arthroscopy 27:681-694
  27. Chen S et al (2005) The effects of thermal capsular shrinkage on the outcomes of arthroscopic stabilization for primary anterior shoulder instability. Am J Sports Med 33:705-711
  28. Protzman RR (1980) Anterior instability of the shoulder. J Bone Joint Surg Am 62:909-918
  29. Pelet S, Jolles BM, Farron A (2006) Bankart repair for recurrent anterior glenohumeral instability: results at twenty-nine years' follow-up. J Shoulder Elbow Surg 15:203-207
  30. Fredriksson AS, Tegner Y (1991) Results of the Putti-Platt operation for recurrent anterior dislocation of the shoulder. Int Orthop 15:185-188
  31. Hovelius L, Thorling J, Fredin H (1979) Recurrent anterior dislocation of the shoulder. Results after the Bankart and Putti-Platt operations. J Bone Joint Surg Am 61:566-569
  32. Konig DP et al (1997) Osteoarthritis and recurrences after Putti- Platt and Eden-Hybbinette operations for recurrent dislocation of the shoulder. Int Orthop 21:72-76
  33. Varmarken JE, Jensen CH (1989) Recurrent anterior dislocation of the shoulder. A comparison of the results after the Bankart and the Putti-Platt procedures. Orthopedics 12:453-455
  34. Magnusson L et al (2002) Revisiting the open Bankart experience: a four- to nine-year follow-up. Am J Sports Med 30:778-782
  35. Lenters TR et al (2007) Arthroscopic compared with open repairs for recurrent anterior shoulder instability. A systematic review and meta-analysis of the literature. J Bone Joint Surg Am 89:244-254
  36. Freedman KB et al (2004) Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder: a meta-analysis. Am J Sports Med 32:1520-1527
  37. Petrera M et al (2010) A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc 18:1742-1747
  38. MacDonald PB et al (1992) Release of the subscapularis for internal rotation contracture and pain after anterior repair for recurrent anterior dislocation of the shoulder. J Bone Joint Surg Am 74:734-737
  39. Regan WD Jr et al (1989) Comparative functional analysis of the Bristow, Magnuson-Stack, and Putti-Platt procedures for recurrent dislocation of the shoulder. Am J Sports Med 17:42-48
  40. Hashiuchi T et al (2000) The changes occurring after the Putti- Platt procedure using magnetic resonance imaging. Arch Orthop Trauma Surg 120:286-289
  41. Hovelius L, Saeboe M (2009) Neer Award 2008: arthropathy after primary anterior shoulder dislocation-223 shoulders prospectively followed up for twenty-five years. J Shoulder Elbow Surg 18:339-347
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