The results of the Putti-Platt operation with particular reference to arthritis, pain, and limitation of external rotation

The results of 90 primary Putti-Platt operations were studied with an average follow-up of 9 years. Seventy of the patients underwent a clinical examination, a functional assessment, and radiologic examination and completed a questionnaire. Twenty patients completed only the questionnaire. The redislocation rate was 9%. Eleven percent of the patients had pain at rest, and 35% had pain on activity. Ninety percent of the patients had restriction of external rotation both at the side of the body (average loss 24°) and in 90° abduction (average loss 23°). Twenty (29%) of the shoulders showed moderate and 1 (1%) shoulder severe osteoarthritis. Only 3 (4%) of the nonoperated shoulders showed moderate arthritis, and none had severe arthritis. Eighty-three percent of patients were fully satisfied, 13% were partly satisfied, and 4% were not satisfied with the result of the operation. The authors conclude that the incidence and severity of osteoarthritis, the incidence of pain, and the limitation of external rotation are significantly increased after the Putti-Platt operation. (J Shoulder Elbow Surg 1998;7:495-500.)