Capsuloplasty for the treatment of recurrent anterior dislocation of the shoulder: long-term evaluations of the Putti-Platt method and Bankart method with anchors.

The authors compare two methods used for the treatment of recurrent anterior shoulder dislocations: Putti-Platt capsulomyoplasty, based on an overlapping suture of the free margins of the joint capsule and of the subscapularis muscle, and the Bankart method that uses anchors, based on the repair of the glenoid labrum, that is kept in site, together with the medial flap of the joint capsule, by suturing with the anchors previously stabilized to the neck of the glena. In this method, the subscapularis muscle is re-approximated without any overlapping or shortening. The Bankart method with anchors thus allows us to obtain anatomical repair of the lesion, with doubtless advantages for mobility, function and stability of the shoulder; this is confirmed by the comparison with results obtained out of 34 patients in this study, 15 of which submitted to the Putti-Platt method, 19 to the Bankart method with anchors. The latter had reduction of external rotation which in none of the cases exceeded 25% (a reduction that at times achieved 50% in patients submitted to the Putti-Platt method (p = 0.001); difficulties in work or sports were minimum or absent (p = 0.003), recovery time was more rapid, without compromising joint stability (p = 0.069); these data allow us to consider the Bankart method with anchors the surgical method that is most indicated for the treatment of anterior glenohumeral instability.