Arthroscopic Bankart repair is used to repair torn capsulolabral tissues—the labrum, capsule, and ligaments—after shoulder dislocation. These tissues can tear when the shoulder dislocates and leave the shoulder unstable. The goal of surgery is to repair the torn structures and stabilize the shoulder to help prevent further instability or dislocations.
What Is Arthroscopic Bankart Repair?
A Bankart lesion is a tear of the labrum and capsular ligaments away from the glenoid, or socket of the shoulder joint. Bankart tears may occur with anterior, posterior, or inferior shoulder dislocations.
Dr. Chudik uses an arthroscopic approach through small incisions, less than 1 cm, to repair the torn capsule, ligaments, and labral tissues.
Bio-absorbable anchors are inserted into the edge of the glenoid (socket) bone. Sutures attached to the anchors are passed through the torn edge of the soft tissue and tied to repair the capsule, ligaments, and labrum.
The overall goal is to restore the torn tissues to their proper position and stabilize the shoulder.
Who Is a Candidate?
Surgery for shoulder instability may be indicated for people who have recurrent shoulder dislocations, subluxations, or symptoms that affect daily activities, work, sports, or recreation.
For anterior shoulder dislocations, surgery may be recommended for young, active individuals after their first dislocation because young patients have a high likelihood—80 percent or greater—of recurrent dislocations. Older patients with an anterior dislocation are less likely to re-dislocate and may do well without surgery as long as they do not sustain a fracture or rotator cuff tear with the dislocation.
For posterior shoulder dislocations, surgery may be recommended for young, active individuals because of persistent pain or instability and to prevent the potential risk for posterior eccentric wear and arthritis.
For inferior shoulder dislocations, surgery may similarly be recommended for young, active individuals because of persistent pain or instability and to prevent the potential risk for inferior eccentric wear and arthritis.
Surgery may not be appropriate in the presence of:
- Infection
- Significant pre-operative shoulder stiffness
- Shoulder arthritis
- An inability or unwillingness to complete the postoperative program, including sling or immobilizer use and the necessary rehabilitation
How the Procedure Is Performed
Arthroscopic Bankart repair is performed as outpatient surgery, allowing patients to go home the same day. General anesthesia with an interscalene block is used.
Dr. Chudik performs the repair through small arthroscopic incisions measuring less than 1 cm. Bio-absorbable anchors are inserted into the edge of the glenoid (socket), and sutures attached to the anchors are passed through the torn soft tissues.
The sutures are then tied to repair the torn capsule, ligaments, and labrum.
Following surgery, immobilization in a sling for six weeks allows the repaired labrum, capsule, and ligaments to heal in the proper position.
Recovery and Rehabilitation
Following surgery:
- Shoulder motion is restricted in a sling for six weeks to protect the repair and allow healing.
- The sling is worn at all times except for bathing, dressing, and exercises, including while sleeping.
- Driving is restricted for six weeks.
- Patients may return to school or sedentary work in less than one week as long as the shoulder remains in the sling.
- Physical therapy should begin two to three days after surgery and continue for four to six months.
The success of shoulder surgery is highly dependent on postoperative rehabilitation, making it important to follow and maintain the prescribed therapy schedule.
Return to activity depends on the type of activity, sport, and position, as well as whether the injured arm is dominant or non-dominant. At least four to six months is generally required before returning to sports or strenuous labor.
Full shoulder motion and strength are necessary before returning to sports or strenuous labor. Dr. Chudik also recommends and provides additional shoulder stabilization training and testing to help determine when it is safe to return to sports.
Risks and Outcomes
Potential surgical risks and complications include:
- Infection
- Injury to nerves of the shoulder or arm, which may cause numbness, weakness, or paralysis and can also occur with the dislocation itself
- Re-injury and recurrence of instability, including re-dislocation or subluxation
- Continued pain
- Stiffness or loss of shoulder motion
- Inability to return to the same level of competition
- Irritation from sutures, which is rare
- Arthritis
By approximately four to six months following surgery, the repair site has generally healed sufficiently for shoulder motion, strength, and function to be restored enough to allow a full return to activities.
Why Dr. Chudik for Arthroscopic Bankart Repair
Dr. Chudik uses an arthroscopic approach through small incisions to repair torn capsular, ligament, and labral tissues associated with anterior, posterior, and inferior shoulder instability.
He also provides additional shoulder stabilization training and return-to-sport testing following rehabilitation to help determine when the shoulder has been fully rehabilitated and when it is safe to return to sports.