Arthroscopic Bankart repair restores the torn glenoid labrum and capsule to the rim of the glenoid, addressing the underlying anatomic injury that produces shoulder instability after dislocation. The procedure is performed through small arthroscopic incisions and is the standard surgical treatment for symptomatic anterior, posterior, and inferior Bankart tears in active patients.
What Is Arthroscopic Bankart Repair?
A Bankart tear is the detachment of the labrum and attached capsule from the rim of the glenoid, typically following a shoulder dislocation. Bankart tears are classified by location: anterior (most common, from anterior dislocation), posterior (from posterior dislocation, common in football blocking and bench pressing), and inferior (from severe trauma or in association with multidirectional instability).
Arthroscopic Bankart repair reattaches the torn labrum and capsule to the glenoid rim using suture anchors. The repair restores the native anatomy of the labrum and the tension of the glenohumeral ligaments, eliminating the structural cause of recurrent instability.
The same arthroscopic principles apply to all three Bankart variants, with the surgical approach modified based on the location of the tear:
- Anterior Bankart Repair: portals positioned anteriorly to access the front of the glenoid; the most common pattern
- Posterior Bankart Repair: posterior portals to access the back of the glenoid; specific to posterior instability
- Inferior Bankart Repair: combined anterior and inferior portal placement; often performed alongside capsular plication for multidirectional patterns
Who Is a Candidate?
Candidates typically have:
- Recurrent shoulder instability after dislocation
- A first-time dislocation in a young athlete (under 25), where re-dislocation rates without surgery are very high
- A symptomatic Bankart tear documented on MRI
- Failure of non-surgical management
- Glenoid bone loss less than 13 to 15 percent (greater bone loss requires Bony Bankart Repair and Glenoid Reconstruction, a technique developed by Dr. Chudik)
Patients with significant glenoid bone loss, large engaging Hill-Sachs lesions, or chronic capsular insufficiency may require additional procedures.
How the Procedure Is Performed
Arthroscopic Bankart repair is performed through three to four small incisions (portals) around the shoulder. A camera (arthroscope) is inserted through one portal, and instruments through the others. The joint is examined to confirm the tear and identify any associated injuries (Hill-Sachs lesion, SLAP tear, rotator cuff pathology).
The torn labrum is mobilized off the glenoid neck where it has scarred down. The glenoid rim is prepared with a small burr to create a healing surface. Suture anchors are placed in the rim, typically three to five for a standard repair. Sutures from the anchors are passed through the labrum and capsule and tied to reattach the tissue to the bone.
For posterior Bankart repair, the camera is moved to a different portal to access the back of the glenoid. For inferior Bankart with multidirectional involvement, capsular plication is added to reduce capsular volume.
Recovery and Rehabilitation
Recovery follows a protected protocol to allow the labrum to heal to bone:
- Sling protection for four to six weeks with passive range of motion within safe limits
- Progressive active motion from six weeks
- Strengthening from three months
- Return to non-contact sport at four to five months
- Return to contact sport at five to six months pending strength and stability testing
Risks and Outcomes
Risks include recurrent instability (5 to 10 percent in standard cases, higher with significant bone loss), stiffness, infection, and nerve injury. Outcomes are best when the tear is repaired before multiple dislocations have occurred, because the labral tissue is healthier and bone loss is less.
For active patients with first-time dislocations, arthroscopic Bankart repair has been shown to significantly reduce re-dislocation rates compared to non-surgical treatment and is the standard of care.
Why Dr. Chudik for Arthroscopic Bankart Repair
Dr. Chudik treats the full spectrum of shoulder instability, from first-time dislocations to complex revision cases. He has developed arthroscopic techniques for instability cases that fall outside standard repair, including the Arthroscopic Bony Bankart Repair and Glenoid Reconstruction procedure for cases with significant glenoid bone loss. For routine Bankart tears, his arthroscopic experience and high case volume produce reliable outcomes.