Efficacité de l’intervention de Latarjet dans l’instabilité d’épaule chez l’épileptique

Abstract

IntroductionPowerful 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. HypothesisIs Latarjet procedure effective in epileptic patients as non-epileptic patients with anterior shoulder instability? Material and methodEleven 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. ResultsThree (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). DiscussionEpileptic 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 evidenceIII (case-control study).