title: Results of the Latarjet procedure for recurrent anterior dislocation of the shoulder in patients with epilepsy.
abstract: A total of 12 epileptic patients (14 shoulders)   with recurrent seizures and anterior dislocations of the shoulder underwent   a Latarjet procedure and were reviewed at a mean of 8.3 years (1   to 20) post-operatively. Mean forward flexion decreased from 165° (100° to 180°)   to 160° (90° to 180°) (p = 0.5) and mean external rotation from 54° (10° to 90°)   to 43° (5° to 75°) (p = 0.058). The mean Rowe score was 76 (35 to   100) at the final follow-up. Radiologically, all shoulders showed   a glenoid-rim defect and Hill-Sachs lesions pre-operatively. Osteo-arthritic changes   of the glenohumeral joint were observed in five shoulders (36%)   pre-operatively and in eight shoulders (57%) post-operatively.   Re-dislocation during a seizure occurred in six shoulders (43%).   Five of these patients underwent revision surgery using a bone buttress   from the iliac crest and two of these patients re-dislocated due   to a new seizure.  Due to the unacceptably high rate of re-dislocation after surgery   in these patients, the most important means of reducing the incidence   of further dislocation is the medical management of the seizures.   The Latarjet procedure should be reserved for the well-controlled   patient with epilepsy who has recurrent anterior dislocation of   the shoulder during activities of daily living.
authors.affiliation: Clinic for Orthopaedic & Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Raiss
authors.forename: A
authors.initials: A
authors.lastname: Lin
authors.forename: N
authors.initials: N
authors.lastname: Mizuno
authors.forename: B
authors.initials: B
authors.lastname: Melis
authors.forename: G
authors.initials: G
authors.lastname: Walch
mesh_terms: D000328:Adult; D004827:Epilepsy / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D012008:Recurrence; D012086:Reoperation; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult