Management of Shoulder Instability in Patients with Seizure Disorders

Atwan, Yousif; Wang, Allen; Labrum, Joseph T; Sanchez-Sotelo, Joaquín; Barlow, Jonathan D.; Dines, Joshua S.; Camp, Christopher L.

doi:10.1007/s12178-023-09833-3

Cited by 5 publications

(4 citation statements)

References 51 publications

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“…They are more likely to suffer multiple dislocations compared to patients without seizure disorder, those with it have been found to have a significantly higher recurrence rate of dislocations after surgical management. It is proposed that this may be due to further seizure activity post-operatively or perhaps significant bone loss prior to surgical intervention ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the widespread utility of a double-row suture bridge was shown in the demonstrative case. The patient had a 25% to 30% glenoid defect glenoid bony lesion and a history of recurrent anterior shoulder instability in the setting of seizure disorder, a classically challenging patient population to successfully treat ( 25 ). To date, she has shown no recurrence of instability and remains asymptomatic in the immediate postoperative setting.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic suture bridge fixation for acute bony Bankart with anterior glenohumeral instability: a case report and narrative review

St. Jeor,

Mason,

Glover

et al. 2024

Ann Joint

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Background and Objective Anterior shoulder dislocations can result in acute glenoid rim fractures that compromise the bony stability of the glenohumeral joint. Adequate fixation of these fractures is required to restore stability, decrease shoulder pain, and facilitate return to activity. The double-row suture bridge is a relatively novel fixation technique, first described in 2009, that accomplishes internal fixation with sufficient stability using an all-arthroscopic technique to restore the glenoid footprint. A 40-year-old female with recurrent anterior shoulder instability in the setting of seizure disorder was found to have a bony Bankart lesion of 25% to 30% with a concomitant superior labral tear. The patient was treated with a double-row bony Bankart bridge and labral repair. At six months follow-up, she has progressed to a full recovery with no recurrence. Methods A search was conducted in May 2023 in PubMed, EMBASE, and CINAHL with the search terms bony Bankart, bone Bankart, osseous Bankart, acute, bridge, suture bridge, double row. Key Content and Findings Double-row suture bridge repairs result in improvement in shoulder function as determined by ASES (93.5), QuickDASH (4.5), SANE (95.9), and SF-12 (55.6). The overall recurrence rate of anterior instability after a bony Bankart bridge repair is 8%. When examining the return to prior level of function, 81.4% of patients were able to do so with only 7.9% of patients reporting significant modifications to their activity level. In mid-term results, double row suture bridge demonstrates similar outcomes to other all-arthroscopic fixation methods of bony Bankart injuries. Importantly, bony Bankart bridge remains a viable option for critical glenoid lesions over the 20% cutoff used in other all arthroscopic techniques. Biomechanically, the double-row suture bridge offers distinct benefits over its single-row counterpart including increased compression, reduced displacement, and reduced step-off. Conclusions Although there is limited data, the studies discussed and the demonstrative case show the potential benefit of all-arthroscopic double-row suture bridge fixation including increased compression, decreased displacement, and a lower complication rate in patients with large bony Bankart lesions traditionally requiring bony augmentation. However, more robust studies are necessary to determine the long-term success of the double-row suture bridge.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Arthroscopic suture bridge fixation for acute bony Bankart with anterior glenohumeral instability: a case report and narrative review

St. Jeor,

Mason,

Glover

et al. 2024

Ann Joint

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“…SDs are the most common cause of recurrent posterior shoulder dislocation [ 1 ], and recurrent anterior shoulder dislocations (RASDs) are the most common type of shoulder dislocation in SDs [ 1 ]. Recent studies have reported the incidence of RASD to range from 65% to 86% [ 4 - 7 ]. The problems unique to RASD in SDs are 1, a large anterior bony Bankart lesion; 2, an engaging Hill-Sach's lesion; 3, significant attritional bone loss; 4, osteoporosis of the glenoid and humeral bones under the effect of anti-epileptic medications; 5, a history of irregular treatment; 6, associated psychiatric disorders; and 7, a history of substance abuse [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The treatment options for recurrent instability due to SDs include the Putti-Platt procedure, Bankart's repair with/without remplissage, capsular shift, bone block procedure, coracoid transfer, glenoid neck/humeral osteotomy, arthrodesis, and arthroplasty [ 7 ]. Recent investigations have narrated management options for recurrent shoulder instability; however, the studies did not follow methods of systematic search and critical appraisal [ 4 , 5 , 7 ]. The primary objective of this review was to analyze the safety and efficacy of operative interventions for recurrent anterior dislocation in SD.…”

Section: Introductionmentioning

confidence: 99%

Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis

Rai,

Chouhan,

Nema

et al. 2024

Clin Shoulder Elb

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Background: Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%–80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs.Methods: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded.Results: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.36–10.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases.Conclusions: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD.Level of evidence: III

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Distal Radius Allograft for Glenoid Reconstruction in Anterior Shoulder Instability With Significant Glenoid Bone Loss

Fares,

Boufadel,

Cox

et al. 2024

Arthroscopy Techniques

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Management of Shoulder Instability in Patients with Seizure Disorders

Cited by 5 publications

References 51 publications

Arthroscopic suture bridge fixation for acute bony Bankart with anterior glenohumeral instability: a case report and narrative review

Arthroscopic suture bridge fixation for acute bony Bankart with anterior glenohumeral instability: a case report and narrative review

Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis

Distal Radius Allograft for Glenoid Reconstruction in Anterior Shoulder Instability With Significant Glenoid Bone Loss

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