Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis

• Published in: Clinics in Shoulder and Elbow Vol. 27; no. 2; pp. 160 - 168
• Main Authors: Rai, Alok, Chouhan, Dushyant, Nema, Sandeep Kumar, Madegowda, Arkesh, Narayan, Rudra, Kar, Bikram K.
• Format: Journal Article
• Language: English
• Published: 대한견주관절의학회 01-06-2024; Korean Shoulder and Elbow Society; 대한견주관절학회
• Subjects: arthroplasty; epilepsy; latarjet operation; Original; seizure; shoulder dislocation; 정형외과학; Shoulder dislocation; Seizure; Arthroplasty; Latarjet operation; Epilepsy
• ISSN: 2383-8337; 2288-8721
• DOI: 10.5397/cise.2023.00948

Background Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%–80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. Methods Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. Results We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.36–10.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. Conclusions SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD. Level of evidence III.