van der Zwaag H M, Brand R, Obermann W R, Rozing P M
Department of Orthopaedic Surgery, Leiden University Hospital, The Netherlands.
J Shoulder Elbow Surg. 1999 May-Jun;8(3):252-8. doi: 10.1016/s1058-2746(99)90138-6.
The Putti-Platt capsulorraphy for recurrent anterior dislocation of the glenohumeral joint was performed in 139 shoulders between 1955 and 1985. Sixty-six (46%) operated shoulders were studied with a mean follow-up period of 22 years (range 10 to 40 years). There were 52 shoulders of men and 14 shoulders of women; 45% of the shoulders were on the dominant side. Two patients underwent surgery on both shoulders. The average age of the patients was 49.3 years (range 33 to 74 years). Evaluation was based on patient history and the results of physical examination and radiography. The redislocation rate was low (only 3%), and 71% of the patients did not have pain, strength loss, stiffness, or instability in the operated shoulder. Radiographs were made of all shoulders, including the nonoperated shoulders. Osteoarthrotic changes of the glenohumeral joint were found in 40 (61%) shoulders. Arthrosis was mild in 23 (35%) shoulders, moderate in 13 (20%) shoulders, and severe in 4 (6%) shoulders. The rate of glenohumeral arthrosis is increased in patients who have undergone a Putti-Platt procedure and is positively correlated with the length of time since surgery. No correlation was found in this study between external rotation at 6 months after operation and the development of glenohumeral arthrosis. The number of dislocations before operation was correlated with the severity of arthrosis but not with its incidence.
1955年至1985年间，对139例肩关节复发性前脱位患者施行了普蒂-普拉特关节囊缝合术。对其中66例（46%）接受手术的肩关节进行了研究，平均随访期为22年（范围10至40年）。男性患者52例，女性患者14例；45%的肩关节位于优势侧。2例患者双侧肩关节均接受了手术。患者的平均年龄为49.3岁（范围33至74岁）。评估基于患者病史、体格检查结果及影像学检查。再脱位率较低（仅3%），71%的患者手术侧肩关节无疼痛、力量丧失、僵硬或不稳定。对所有肩关节均进行了X线检查，包括未手术侧肩关节。40例（61%）肩关节发现有盂肱关节骨关节炎改变。23例（35%）肩关节的关节炎为轻度，13例（20%）为中度，4例（6%）为重度。接受普蒂-普拉特手术的患者盂肱关节关节炎发生率增加，且与术后时间长短呈正相关。本研究未发现术后6个月时的外旋与盂肱关节关节炎的发生之间存在相关性。术前脱位次数与关节炎的严重程度相关，但与关节炎的发生率无关。
