Traumatic shoulder dislocations can result in a bony Bankart lesion, in which bone is fractured off the rim of the glenoid (socket of the shoulder joint). These injuries can leave the shoulder unstable and prone to repeat dislocations.
Dr. Chudik performs arthroscopic surgery through small incisions to repair a bony Bankart fracture or reconstruct the glenoid when bone is deficient, while also repairing torn soft tissues. He has designed a procedure and instruments to arthroscopically repair or replace missing glenoid bone.
What Is Arthroscopic Bony Bankart Repair and Glenoid Reconstruction?
The head of the humerus (ball of the upper arm bone) is stabilized against the glenoid (socket of the shoulder joint) by a combination of muscles, the labrum, and ligaments.
When the humeral head is forced out of place during a dislocation, the soft tissues can stretch or tear. In some cases, bone can also fracture off the glenoid rim, resulting in a bony Bankart lesion.
Dislocations that result in bony Bankart lesions typically leave the shoulder unstable and prone to repeat dislocations. If dislocations continue, the glenoid can erode and become deficient, decreasing the size of the surface on which the humerus sits.
In these cases, repairing only the supportive soft tissues surrounding the shoulder joint may be inadequate. Reconstruction of the glenoid using a bone graft can address the deficient bone, repair torn soft tissues, and restore shoulder function and stability.
Development Rationale
Dr. Chudik has designed a procedure and instruments to arthroscopically repair or replace missing glenoid bone.
Using a camera and small incisions, he can repair a bony Bankart fracture or reconstruct the glenoid while also repairing torn soft tissues within the shoulder.
His technique allows the missing or deficient glenoid bone to be addressed arthroscopically using specialized instruments, including Dr. Chudik’s bony Bankart repair guide.
Who Is a Candidate?
Patients with pain and instability following a shoulder dislocation and bony Bankart injury may be candidates for bony Bankart repair.
Patients who experience continued dislocations may develop erosion and deficiency of the glenoid. In these cases, repair of the supportive soft tissues alone may be inadequate, and reconstructive surgery using a bone graft may be necessary to address the deficient bone and restore shoulder stability.
How the Procedure Is Performed
The procedure 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 surgery arthroscopically using a camera that allows him to view the shoulder through small incisions. He can repair the bony Bankart fracture or reconstruct the glenoid and repair torn soft tissues.
When the glenoid is deficient, a bone graft is used to reconstruct the missing portion of the socket. Dr. Chudik has designed specialized instruments to arthroscopically repair or replace the missing glenoid bone and properly position the bone graft for fixation.
Recovery and Rehabilitation
Following surgery:
- A sling is worn at all times except for bathing, dressing, and exercises for six weeks, including while sleeping.
- Patients may feel more comfortable sleeping upright on a couch or recliner after surgery.
- Following arthroscopic surgery, the wound should remain clean and dry for three days. Light showering may begin after three days, but the wound should not be submerged under water for three weeks.
- Driving may resume after six weeks, once out of the sling.
- Patients may return to school or sedentary work in less than one week as long as the sling is worn.
- 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 required after surgery before returning to sports or strenuous labor. Full shoulder motion and strength are necessary before returning to these activities.
Risks and Outcomes
Potential surgical risks and complications include:
- Infection
- Rare injury to nerves of the shoulder, arm, or hand
- Stretching of the Bankart repair and ligaments over time or with repeat injury
- Breakage of internal fixation devices
- Further fracture of the glenoid with another dislocation mechanism
- Shoulder stiffness, which is uncommon
- Persistent pain with activities
- Need for revision surgery or hardware removal
- Arthritis
Why Dr. Chudik for Arthroscopic Bony Bankart Repair and Glenoid Reconstruction
Dr. Chudik has designed a procedure and specialized instruments to arthroscopically repair or replace missing glenoid bone.
Using a camera and small incisions, he can repair a bony Bankart fracture or reconstruct the deficient glenoid while also repairing torn soft tissues. His specialized bony Bankart repair guide is used to help position the bone graft during reconstruction.