Introduction
Outcomes following Latarjet for anterior shoulder instability in seizure disorder patients are unknown. The purpose of this study was to determine effectiveness of the Latarjet procedure in treating seizure disorder patients with anterior shoulder instability.
Methods
Retrospective review of patients undergoing Latarjet from 2013-2017 for anterior shoulder instability with minimum 2 years of clinical follow-up was performed. Patients were divided into two groups: patients diagnosed with seizure disorder (SD), and patients without a history of seizure (control). Demographics, indications, seizure disorder details, and postoperative outcomes were collected. The incidence of complications, recurrent instability, revision surgery, and repeat seizure(s) were also examined.
Results
53 patients were identified. This included 9 SD patients with 10 shoulders (88.9% male; mean age, 29.2 years), and 44 non-SD patients (86.4% male; mean age, 30.3 years) that underwent the Latarjet procedure for treatment of anterior shoulder instability. The mean follow-up time was 3.4 and 3.8 years in the SD and control group respectively. During the follow-up period, 4/9 (44.4%) SD patients (5/10, 50% shoulders) had a recurrent seizure post-operatively. Three patients sustained a recurrent dislocation of the operative shoulder(s), including one who dislocated bilateral shoulders from a single seizure event. Having a seizure in the post-operative period significantly increase the risk of recurrent dislocation (OR=39.9,p=.04)
Conclusion
Latarjet is a successful operation for recurrent dislocations with bone loss, even in patients with seizure disorder. Adequate control of seizures both pre- and post-operatively is paramount to prevent further dislocations. Patients in this group can be advised that if their seizures can remain controlled, they have a high likelihood of clinical success.