Latarjet procedure for patients with pre-existing seizure disorders vs. controls: a systematic review and meta-analysis.

Abstract

The purpose of this study was to systematically review the literature to ascertain the clinical outcomes of the Latarjet procedure in patients with seizure disorders (SDs) vs. controls. Two independent reviewers performed a literature search using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines using PubMed, Embase, and Scopus databases. Only studies reporting on outcomes of the Latarjet procedure comparing patients with pre-existing SDs or those comparing such patients vs. controls were considered for inclusion. A meta-analysis was performed on clinical outcomes compared using RevMan. The search found 5 studies including 237 shoulders (78% males), with an average age of 28.9 ± 2.5 years (19-55) and mean follow-up of 55 ± 31.7 months (12-240). Both the control and SD groups reported significant increases in the Rowe and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form scores postoperatively (both P < .001). Additionally, there were significantly higher Rowe scores reported in the control group post-Latarjet procedures when compared to the SD group (94.4 ± 0.1 vs. 85.2 ± 7.9, P < .001). The meta-analysis demonstrated that there were significantly higher recurrence rates and revision rates in those who underwent a Latarjet procedure with pre-existing SD, vs. those in the control group (11.2% vs. 2.5%, P = .01) and 14.3% vs. control 0.01% (P < .01). Our review found that patients with pre-existing SD were significantly more likely to report higher rates of postoperative recurrence and poorer functional outcomes following a Latarjet procedure, when compared to controls. Therefore, the presence of pre-existing SD warrants consideration in the management algorithm for patients with anterior shoulder instability.