O'Sullivan David, Davey Martin S, Hurley Eoghan T, Dickens Jonathan F, Mullett Hannan
Royal College of Surgeons in Ireland, Dublin, Ireland; UPMC Sports Surgery Clinic, Dublin, Ireland.
Royal College of Surgeons in Ireland, Dublin, Ireland; UPMC Sports Surgery Clinic, Dublin, Ireland.
J Shoulder Elbow Surg. 2025 Jul;34(7):1841-1846. doi: 10.1016/j.jse.2024.10.002. Epub 2024 Dec 3.
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.
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.
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).
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.
本研究旨在系统回顾文献，以确定拉塔热手术治疗癫痫障碍（SD）患者与对照组的临床结果。
两名独立评审员按照系统评价和Meta分析的首选报告项目（PRISMA）指南，使用PubMed、Embase和Scopus数据库进行文献检索。仅纳入报告拉塔热手术结果并比较已有SD患者或比较此类患者与对照组的研究。使用RevMan对临床结果进行Meta分析。
检索发现5项研究，共237例肩部病例（78%为男性），平均年龄28.9±2.5岁（19 - 55岁），平均随访时间55±31.7个月（12 - 240个月）。对照组和SD组术后Rowe评分及美国肩肘外科医师协会标准化肩部评估表评分均显著提高（均P < 0.001）。此外，与SD组相比，拉塔热手术后对照组的Rowe评分显著更高（94.4±0.1对85.2±7.9，P < 0.001）。Meta分析表明，已有SD的患者接受拉塔热手术后的复发率和翻修率显著高于对照组（11.2%对2.5%，P = 0.01）以及14.3%对对照组0.01%（P < 0.01）。
我们的综述发现，与对照组相比，已有SD的患者在接受拉塔热手术后报告的术后复发率显著更高，功能结果更差。因此，在处理前肩不稳患者的管理算法中，应考虑已有SD的情况。
