Anterior Shoulder Instability with Epilepsy: Bankart Repair Versus Latarjet Procedure

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Anterior shoulder instability in epilepsy patients presents significant treatment challenges and high recurrence rates.
• Epilepsy-associated anterior glenohumeral instability requires specific surgical considerations.

Purpose of the Study:

• To compare arthroscopic Bankart repair versus the open Latarjet procedure for anterior shoulder instability in epilepsy patients.
• To compare the outcomes of the open Latarjet procedure in epilepsy and non-epileptic patient groups.

Main Methods:

• A study included 57 shoulders in 55 patients (18-50 years) with anterior glenohumeral instability.
• 21 epilepsy patients (23 shoulders) underwent either arthroscopic Bankart repair (12) or open Latarjet (11).
• Comparisons were made between epilepsy and non-epilepsy patients (34) who had the Latarjet procedure.

Main Results:

• In epilepsy patients, Bankart repair (on-track lesions) and Latarjet (off-track lesions) showed no significant difference in outcomes or recurrence.
• The Latarjet procedure had a 45% re-dislocation rate in epilepsy patients versus 14% in non-epilepsy patients, with seizures causing 4 dislocations.
• Recurrence rates were high for both procedures in epilepsy patients, with Bankart repair for on-track lesions similar to Latarjet for off-track lesions.

Conclusions:

• The Latarjet procedure offers similar functional outcomes to the Bankart repair in epilepsy patients but with a higher re-dislocation rate.
• High re-dislocation rates, often seizure-related, were observed with both surgical methods in epilepsy patients.
• The Latarjet procedure is recommended for anterior stabilization in epilepsy patients due to the high recurrence risk associated with arthroscopic Bankart repair.