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Comparative Study
. 2025 Feb;17(1):157-165.
doi: 10.4055/cios24124. Epub 2024 Dec 9.

Anterior Shoulder Instability with Epilepsy: Bankart Repair Versus Latarjet Procedure

Sung Min Rhee  1 , Chang Woo Woo  2 , Cheol Hwan Kim  2 , Dong Hyun Kim  2 , Yong Girl Rhee  2
Affiliations
Comparative Study

Anterior Shoulder Instability with Epilepsy: Bankart Repair Versus Latarjet Procedure

Sung Min Rhee et al. Clin Orthop Surg. 2025 Feb.

Abstract

Backgroud: Anterior dislocation in epilepsy patients is relatively severe, difficult to treat, and prone to recurrence. The purpose of this study was to compare the results of arthroscopic Bankart repair and the open Latarjet procedure in epilepsy patients who had anterior shoulder instability and to compare the results of the open Latarjet procedure in epilepsy and non-epileptic groups.

Methods: A total of 57 shoulders (34 dominant) in 55 patients (18-50 years, 45 men and 10 women) with anterior glenohumeral instability were included in the study and the average follow-up was 24 months. Out of 21 epilepsy patients (23 shoulders), 11 were treated with the open Latarjet procedure and 12 with arthroscopic Bankart repair. Additionally, comparisons were made between the 34 non-epileptic patients who underwent the open Latarjet procedure and the epilepsy patients who underwent the same procedure.

Results: In the epilepsy group, all 12 patients who underwent Bankart repair had on-track lesions, and all 11 patients who underwent the Latarjet procedure had off-track lesions. In the non-epilepsy group, all cases were off-track lesions. In the epilepsy group, there was no significant difference in the postoperative clinical outcome and recurrence rate between the Bankart repair and Latarjet procedure groups. In the Latarjet group, postoperative re-dislocation rate in the non-epilepsy patients was 14% (5/34 cases), compared to 45% (5/11 cases) in the epilepsy patients, 4 of which 4 occurred during seizures. It was 41% in the Bankart repair group for on-track lesions, which was similar to the recurrence rate after the Latarjet for off-track lesions in the epilepsy group.

Conclusions: After the Latarjet procedure, the functional outcomes in the epilepsy group were similar to those in the non-epilepsy group, except for the higher re-dislocation rate. With either of the surgical procedures, the re-dislocation rate secondary to seizures was very high. Despite the presence of on-track lesions, the Latarjet procedure would be more preferrable for anterior stabilization in epilepsy patients, in view of the high recurrence rate with arthroscopic Bankart repair.

Keywords: Bankart; Epilepsy; Joint instability; Latarjet; Shoulder dislocation.

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Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. (A) A 19-year-old epilepsy patient with an on-track lesion in the left shoulder. Arthroscopic view showing a Bankart lesion. (B) A Hill-Sachs lesion. (C) Capsular shift and plication using a suture hook. (D) Complete repair of the Bankart lesion.
Fig. 2
Fig. 2. (A) A 29-year-old epilepsy patient with an off-track lesion and a glenoid defect in the left shoulder on 3-dimensional computed tomography (CT). A Hill-Sachs lesion on CT (B) and magnetic resonance imaging (C). (D-F) Latarjet procedure and humeral head allograft on immediate postoperative x-ray and CT.
See this image and copyright information in PMC

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