Latarjet Procedure For Anterior Shoulder Instability in Epileptic Patients

Abstract

AimThe aim is to evaluate the functional and radiographic results of the Modified Latarjet procedure for anterior shoulder dislocation in patients with epilepsy and compare the functional results of these patients with patients without epilepsy.BackgroundPowerful contractions during epileptic seizures may cause shoulder dislocation and instability. Half of the epileptic shoulder instabilities are anterior instabilities most of them with osseous Bankart or deep Hill-Sachs lesions.Methods12 shoulders of 10 patients with epileptic seizures causing anterior shoulder instability were evaluated retrospectively. All patients had a Modified Latarjet procedure after neurologic treatment arrangement. Epileptic seizures after the operation and redislocation after a seizure were investigated.The functional results of epileptic patients with Modified Latarjet procedure were compared with non-epileptic patients (63 patients, 64 shoulders) with Latarjet procedure for anterior shoulder instability.ResultsAfter mean follow-up of 40(6-114) months Four (40%) of the 10 epileptic patients had recurrent seizures after Latarjet procedure, whereas 2 of the 12 shoulders (16%) had dislocation after an epileptic seizure. Both redislocations occurred in the first postoperative week before the graft union can occur.Functional scores were found to be significantly improved in epileptic (p<0.001) and non- epileptic patients (p<0.001). No significant differences for functional results were found between epileptic and non-epileptic patients after Latarjet procedure (p>0.05). Two shoulders of 12 in the patients with epilepsy group (16 %) and one shoulder of the 64 shoulders non-epileptic patients group (1.5 %) had a redislocation which is significantly higher ( p:0.013)ConclusionsEpileptic patients has a high rate of recurrent seizures even with proper medical treatment. Weeks before the graft union may be critical since seizures before union may cause failure. Functional improvements and stability may be achieved after Modified Latarjet procedure in epileptic patients. These functional results were comparable with those of non-epileptic patients with Latarjet procedure.