A new study comparing outcomes of 19 epileptic patients to outcomes of 21 non-epileptic patients provides evidence that Latarjet is effective when used for shoulder stabilization.
In the study, “Outcomes of Arthroscopic Latarjet Procedure for Anterior Glenohumeral Instability in Patients With Epilepsy: A Case-Control Study,” published online on January 12, 2022 in The American Journal of Sports Medicine, the researchers evaluated Latarjet procedure outcomes of patients with epilepsy versus patients without the condition.
“Unacceptably high rates of re-dislocation, reoperation, osteoarthritis, and coracoid nonunion have been reported in patients with a seizure disorder after surgery for shoulder instability,” the researchers wrote.
For the retrospective and comparative case-control analysis of patients, 19 patients with epilepsy were matched with 21 patients without a history of the seizure disorder. The researchers collected data on demographics, surgical indications, and imaging data. The analysis included up to 2 years of clinical outcomes after the procedure.
Outcomes included Rowe score, Western Ontario Shoulder Instability Index, Constant-Murley Shoulder Outcome score and Single Assessment Numeric Evaluation.
The researchers also determined incidences of complications, recurrent instability, re-dislocation, revision surgery, repeated seizures, and the presence of osteoarthritis, coracoid nonunion and osteolysis.
Over a follow-up of almost 5 years, the researchers found no significant differences in functional outcomes between patients with and without epilepsy on Rowe (p = .917), Western Ontario Shoulder Instability Index (p = .621), Constant-Murley Shoulder Outcome score (p = .600), and Single Assessment Numeric Evaluation (p = .859) scores.
Overall, 5 patients continued to have seizures postoperative, but no seizure-related glenohumeral instability. The researchers noted that 1 dislocation and 1 subluxation occurred during sports activities in each group. The recurrence rate was 9.5%.
Bone defects did not influence outcomes, they also reported. They observed osteoarthritic changes of the glenohumeral joint in 5 shoulders in the epilepsy group and in 3 among the matched controls.
They also did not observe any cases of coracoid nonunion or osteolysis.
In addition, while there was no significant difference in postoperative athletic activity between the two groups, patients with epilepsy did have lower pre- and postoperative sports participation.
“Arthroscopic Latarjet stabilization can lead to improved functional and subjective outcomes and should be considered in patients with epilepsy with recurrent anterior glenohumeral instability. These results can be achieved regardless of the presence of bone defect and the postoperative control of seizure and are similar to those in patients without epilepsy,” the researchers wrote.
Study authors included Lika Dzidzishvilli, M.D., of Hospital Universitario Fundación Jiménez Díaz in Madrid, Spain, Claudio Calvo, M.D., of Pontificia Universidad Católica de Chile in Santiago De Chile, Chile and Maria Valencia, M.D., and Emilio Calvo, M.D. of Hospital Universitario Fundación Jiménez Díaz.
