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

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.