Latarjet Procedure for Patients with Pre-Existing Seizure Disorders Versus Controls: A Systematic Review & 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 (SD) versus 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 versus controls were considered for inclusion. Meta-analysis was performed on clinical outcomes compared using RevMan.

Results: The search found five 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 ASES scores postoperatively (both p < 0.001). 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 <0.001). Meta-analysis demonstrated that there were significantly higher recurrence rates and revision rates in those who underwent a Latarjet procedure with pre-existing SD, versus those in the control group (11.2% vs 2.5%, p= 0.01) and 14.3 % vs control 0.01 % (p < 0.01).

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 paradigm for patients with anterior shoulder instability.