The management of recurrent shoulder instability in patients with epilepsy: a 15-year experience

Anatomical shoulder arthroplasty in epileptic patients with instability arthropathy and persistent seizures

“…In one study, over 50% of epileptic patients developed degenerative changes a mean of 12 years after their index dislocation. 4 A number of important factors unique to this patient group are likely to have contributed to this: repetitive articular surface damage resulting from high-energy dislocations, multiple pre-operative dislocations and the high recurrence rate. 4 Further conservative reconstruction becomes an unenviable prospect due to poor bone stock, large joint surface defects and rotator cuff musculotendinous and capsular insufficiency.…”

“…The mean duration of epilepsy in the cohort was 12 years (range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] and all patients suffered from grand mal seizures. Primary dislocation occurred a mean of 13 years (range, 4-22) before surgery.…”

Management of recurrent shoulder instability in patients with epilepsy

“…16,61 Patients are typically young, active men between the ages of 20 and 30 years. 67 Index dislocation often coincides with a seizure in the absence of direct trauma, with subsequent episodes occurring during normal daily activities and further seizures. 67 Recurrent instability is common and occurs in more than two-thirds of cases, with the incidence of anterior and posterior instability differing between published reports.…”

“…67 Index dislocation often coincides with a seizure in the absence of direct trauma, with subsequent episodes occurring during normal daily activities and further seizures. 67 Recurrent instability is common and occurs in more than two-thirds of cases, with the incidence of anterior and posterior instability differing between published reports. 10,67 Treatment protocols vary and encompass a wide range of soft tissue (Putti-Platt, Bankart repair) and bone augmentation strategies (Eden-Hybinette, coracoid transfer, glenoid neck/ humeral osteotomy, arthrodesis).…”

“…67 Recurrent instability is common and occurs in more than two-thirds of cases, with the incidence of anterior and posterior instability differing between published reports. 10,67 Treatment protocols vary and encompass a wide range of soft tissue (Putti-Platt, Bankart repair) and bone augmentation strategies (Eden-Hybinette, coracoid transfer, glenoid neck/ humeral osteotomy, arthrodesis). 10 Despite several technically satisfactory procedures, some patients experience persistent instability and are unable to cope with the disabling symptoms.…”