A Erşen1, S Bayram2, F Birişik1, A C Atalar1, M Demirhan3. 1. Department of Orthopedics and Traumatology, Istanbul University Faculty of Medicine, Çapa Fatih, Istanbul 34050, Turkey. 2. Department of Orthopedics and Traumatology, Istanbul University Faculty of Medicine, Çapa Fatih, Istanbul 34050, Turkey. Electronic address: dr.serkanbayram89@gmail.com. 3. Department of Orthopaedics and Traumatology, Koç University, School of Medicine, Istanbul, Turkey.
Abstract
INTRODUCTION: Powerful contractions during epileptic seizures may cause shoulder dislocation and instability. The aim of the study is to evaluate the functional and radiographic results of the Latarjet procedure for anterior shoulder dislocation in patients with epilepsy and compare the functional results of these patients with the results of patients without epilepsy. HYPOTHESIS: Is latarjet procedure effective in epileptic patients as non-epileptic patients with anterior shoulder instability? MATERIAL AND METHOD: Eleven shoulders of 9 patients with epileptic seizures causing anterior shoulder instability were evaluated retrospectively. All patients had a Latarjet procedure after neurologic evaluation and treatment arrangement. Epileptic seizures after the operation and shoulder dislocation after a seizure were investigated. For functional evaluation, ROWE, ASES and Constant scores were utilized whereas standard X-ray views were used for radiologic evaluation. The results of epileptic patients with Latarjet procedure were compared with non-epileptic patients (53 patients, 54 shoulders) for anterior shoulder instability. RESULTS: Three (33%) of the 9 epileptic patients had recurrent seizures after Latarjet procedure, whereas 1 of the 11 shoulders (9%) had dislocation after an epileptic seizure. 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 for anterior instability (P>0.05). One shoulder of 11 in the patients with epilepsy group (9%) and one shoulder of the 54 shoulders non-epileptic patients group (1.8%) had a redislocation. The rate of postoperative redislocation was significantly higher in patients with epilepsy (P=0.008). DISCUSSION: Epileptic patients have a high rate of recurrent seizures even with proper medical treatment. Significant functional improvements and shoulder stability may be achieved after Latarjet procedure in epileptic patients. These functional results were comparable with those of non-epileptic patients with Latarjet procedure for anterior shoulder instability. LEVEL OF EVIDENCE: III (case-control study).
INTRODUCTION: Powerful contractions during epilepticseizures may cause shoulder dislocation and instability. The aim of the study is to evaluate the functional and radiographic results of the Latarjet procedure for anterior shoulder dislocation in patients with epilepsy and compare the functional results of these patients with the results of patients without epilepsy. HYPOTHESIS: Is latarjet procedure effective in epilepticpatients as non-epilepticpatients with anterior shoulder instability? MATERIAL AND METHOD: Eleven shoulders of 9 patients with epilepticseizures causing anterior shoulder instability were evaluated retrospectively. All patients had a Latarjet procedure after neurologic evaluation and treatment arrangement. Epilepticseizures after the operation and shoulder dislocation after a seizure were investigated. For functional evaluation, ROWE, ASES and Constant scores were utilized whereas standard X-ray views were used for radiologic evaluation. The results of epilepticpatients with Latarjet procedure were compared with non-epilepticpatients (53 patients, 54 shoulders) for anterior shoulder instability. RESULTS: Three (33%) of the 9 epilepticpatients had recurrent seizures after Latarjet procedure, whereas 1 of the 11 shoulders (9%) had dislocation after an epilepticseizure. Functional scores were found to be significantly improved in epileptic (P<0.001) and non-epilepticpatients (P<0.001). No significant differences for functional results were found between epileptic and non-epilepticpatients after Latarjet procedure for anterior instability (P>0.05). One shoulder of 11 in the patients with epilepsy group (9%) and one shoulder of the 54 shoulders non-epilepticpatients group (1.8%) had a redislocation. The rate of postoperative redislocation was significantly higher in patients with epilepsy (P=0.008). DISCUSSION: Epilepticpatients have a high rate of recurrent seizures even with proper medical treatment. Significant functional improvements and shoulder stability may be achieved after Latarjet procedure in epilepticpatients. These functional results were comparable with those of non-epilepticpatients with Latarjet procedure for anterior shoulder instability. LEVEL OF EVIDENCE: III (case-control study).
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