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The Bankart repair versus the Putti-Platt procedure: a randomized study with WOSI score at 10-year follow-up in 62 patients.

Salomonsson B, Abbaszadegan H, Revay S, Lillkrona U - Acta Orthop (2009)

Bottom Line: The less anatomical procedure has been considered quicker and less demanding, but it has been questioned regarding the clinical result.At the 2-year follow-up, we found no difference in muscle strength between patients treated with the two surgical methods and there were no statistically significant differences in the Rowe scores (mean 90 units for both groups).With assessment of pain and general shoulder function, only a small difference was found between the two methods.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. bjorn.salomonsson@ds.se

ABSTRACT

Background and purpose: This randomized study compared clinical results after surgery for posttraumatic shoulder instability with either an anatomical repair or an older, less anatomical but commonly used method. The less anatomical procedure has been considered quicker and less demanding, but it has been questioned regarding the clinical result. We therefore wanted to compare the clinical outcome of the two different procedures. Our hypothesis was that the anatomical repair would give less residual impairment postoperatively.

Methods: Patients with anterior posttraumatic shoulder instability were consecutively randomized on the day before surgery to either a Bankart repair using Mitek GI/GII anchors combined with capsular imbrication (B) (n = 33) or a Putti-Platt procedure (P) (n = 33). Follow-up was performed by examination at 2 years and using a self-evaluation score at 10 years.

Results: At the 2-year follow-up, we found no difference in muscle strength between patients treated with the two surgical methods and there were no statistically significant differences in the Rowe scores (mean 90 units for both groups). Compared to preoperatively, the decrease in external rotation 2 years after surgery was 10 degrees in the P group and 3 degrees in the B group (p = 0.03). 10 years after surgery, 62 of 66 patients replied to a questionnaire sent by mail. It included a self-evaluating quality of life score for shoulder instability (WOSI) for evaluation of their shoulder function. In the P group 15 patients and in the B group 19 patients reported they had experienced either a redislocation or a subluxation with a new feeling of shoulder instability. Mean WOSI score was similar in the P and B groups: 80% and 83%, respectively. The WOSI score was 87% for patients with stable shoulders (n = 28) and 77% for those with unstable shoulders (n= 34) (p = 0.005).

Interpretation: With assessment of pain and general shoulder function, only a small difference was found between the two methods. The WOSI scores for stable shoulders indicated that some shoulders still had impaired function even though the shoulders had become stable.

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Related in: MedlinePlus

The modified Putti-Platt procedure (Symenoides 1991). Right shoulder seen from above.
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Figure 0002: The modified Putti-Platt procedure (Symenoides 1991). Right shoulder seen from above.

Mentions: The Bankart repair with Figure 2. The modified Putti-suture anchors and capsular Platt procedure (Symenoides imbrication (Rockwood Jr 1990). 1991). Right shoulder seen from Right shoulder seen from above. above.


The Bankart repair versus the Putti-Platt procedure: a randomized study with WOSI score at 10-year follow-up in 62 patients.

Salomonsson B, Abbaszadegan H, Revay S, Lillkrona U - Acta Orthop (2009)

The modified Putti-Platt procedure (Symenoides 1991). Right shoulder seen from above.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823213&req=5

Figure 0002: The modified Putti-Platt procedure (Symenoides 1991). Right shoulder seen from above.
Mentions: The Bankart repair with Figure 2. The modified Putti-suture anchors and capsular Platt procedure (Symenoides imbrication (Rockwood Jr 1990). 1991). Right shoulder seen from Right shoulder seen from above. above.

Bottom Line: The less anatomical procedure has been considered quicker and less demanding, but it has been questioned regarding the clinical result.At the 2-year follow-up, we found no difference in muscle strength between patients treated with the two surgical methods and there were no statistically significant differences in the Rowe scores (mean 90 units for both groups).With assessment of pain and general shoulder function, only a small difference was found between the two methods.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. bjorn.salomonsson@ds.se

ABSTRACT

Background and purpose: This randomized study compared clinical results after surgery for posttraumatic shoulder instability with either an anatomical repair or an older, less anatomical but commonly used method. The less anatomical procedure has been considered quicker and less demanding, but it has been questioned regarding the clinical result. We therefore wanted to compare the clinical outcome of the two different procedures. Our hypothesis was that the anatomical repair would give less residual impairment postoperatively.

Methods: Patients with anterior posttraumatic shoulder instability were consecutively randomized on the day before surgery to either a Bankart repair using Mitek GI/GII anchors combined with capsular imbrication (B) (n = 33) or a Putti-Platt procedure (P) (n = 33). Follow-up was performed by examination at 2 years and using a self-evaluation score at 10 years.

Results: At the 2-year follow-up, we found no difference in muscle strength between patients treated with the two surgical methods and there were no statistically significant differences in the Rowe scores (mean 90 units for both groups). Compared to preoperatively, the decrease in external rotation 2 years after surgery was 10 degrees in the P group and 3 degrees in the B group (p = 0.03). 10 years after surgery, 62 of 66 patients replied to a questionnaire sent by mail. It included a self-evaluating quality of life score for shoulder instability (WOSI) for evaluation of their shoulder function. In the P group 15 patients and in the B group 19 patients reported they had experienced either a redislocation or a subluxation with a new feeling of shoulder instability. Mean WOSI score was similar in the P and B groups: 80% and 83%, respectively. The WOSI score was 87% for patients with stable shoulders (n = 28) and 77% for those with unstable shoulders (n= 34) (p = 0.005).

Interpretation: With assessment of pain and general shoulder function, only a small difference was found between the two methods. The WOSI scores for stable shoulders indicated that some shoulders still had impaired function even though the shoulders had become stable.

Show MeSH
Related in: MedlinePlus