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Effectiveness Of Latarjet For Anterior Shoulder Instability In Patients With Seizure Disorder

2021 Congress Paper Abstracts

Effectiveness Of Latarjet For Anterior Shoulder Instability In Patients With Seizure Disorder

Stephen G Thon, MD, UNITED STATES Katherine Branche, BS, UNITED STATES Darby Adele Houck, BA, UNITED STATES Eric C. McCarty, MD, UNITED STATES Adam Seidl, MD, UNITED STATES Armando F. Vidal, MD, UNITED STATES Michelle Wolcott, MD, UNITED STATES Rachel M. Frank, MD, UNITED STATES Jonathan T. Bravman, MD, UNITED STATES

University of Colorado School of Medicine, Department of Orthopedics, Division of Sports Medicine and Shoulder Surgery, Aurora, CO, UNITED STATES


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Summary: 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.


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.


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