2023 ISAKOS Biennial Congress ePoster
Poor Clinical Outcomes and High Rates Of Recurrent Instability After Treating Seizure-Related Shoulder Injuries
Davide Cucchi, MD, Bonn, Deutschland GERMANY
Robert Ossendorff, MD, Bonn GERMANY
Sebastian G. Walter, MD, Cologne GERMANY
Tobias Baumgartner, MD, Bonn GERMANY
Alessandra Menon, MD, Milano, Milano ITALY
Rainer Surges, Prof., Bonn GERMANY
Pietro S. Randelli, MD, Prof., Milan ITALY
Max Julian Friedrich, MD, Bonn GERMANY
University Hospital Bonn, Bonn, GERMANY
FDA Status Not Applicable
Summary
Patients suffering from seizure-related shoulder injuries report only moderate clinical results, inferior to those reported in high-quality trials not restricted to patients with seizures
ePosters will be available shortly before Congress
Abstract
Purpose
Treating seizure-related shoulder injuries is challenging and an evidence-based consensus to guide clinicians is lacking. The aim of this monocentric prospective observational clinical trial was to evaluate patients’ satisfaction and clinical results of a cohort of patients undergoing treatment of seizure-related shoulder injuries and to categorize them according to the lesions characteristics and the chosen treatment, with special focus on patients suffering combined fracture-dislocations.
Methods
Patients referred to a tertiary epilepsy centre suffering from seizure-related shoulder injuries and with a minimum follow-up of one year were included. A quality-of-life assessment instrument (EQ-5D-5L), a district-specific patient reported outcome measure (quick Disabilities of the Arm, Shoulder and Hand questionnaire, qDASH) and a pain assessment tool (Visual Analogue Scale, VAS) were used for the clinical outcome evaluation. Subjective satisfaction and fear of new shoulder injuries was also documented.
Results
Sixty-four patients were included. After a median follow-up of 4.9 years, the mean EQ-5D-5L index value was 0.76 ± 0.22. Mean qDASH was 32.81 ± 24.64 points, with 27.4% of the patients scoring < 15 points (no problems), and 35.5% of the patients > 40 points (severe disability); mean VAS was 23.38 ± 37.20 mm, with 30.0% of the patients scoring > 35 mm (moderate to severe pain). 40.6 % of the patients considered themselves unsatisfied with the treatment due to persistent pain, compromised upper limb function or as a consequence of the complications. Persistent fear of a new shoulder injury was reported in 63.5% of the patients.
Conclusions
Patients suffering from seizure-related shoulder injuries report only moderate clinical results at mid-term follow-up; these results are inferior to those reported in high-quality trials not restricted to patients with seizures. In a high percentage of cases, residual moderate to severe pain and disability persists after treatment. This warrants special care and appropriate counselling when treating this subgroup of patients.