Bankart Repair

What is a Bankart lesion?

The glenohumeral joint, one of four joints within the shoulder girdle, is formed by the juncture of the head of the humerus (upper arm bone) into the glenoid socket of the scapula (shoulder blade). This joint is a ball-and-socket design that enables a wide range of motion at the cost of a higher risk of injury to the soft-tissue restraints (ligaments, tendons, and labrum). A sports-related injury can cause a forward (anterior) shoulder dislocation resulting in damage to the connective tissues surrounding the glenoid labrum. A Bankart lesion, found on the anterior (forward) surface of the glenoid labrum, is the consequence of weakened connective tissues allowing for multiple shoulder dislocations.

What is the treatment for a Bankart lesion?

When the shoulder ligaments are simply stretched, or only partially torn, from their attachment site, conservative therapies may be sufficient in alleviating symptoms. Immobilization of the shoulder with a sling or other device is highly recommended to prevent further damage during the healing process. Pain and inflammation can be controlled with a combination of rest, ice, and non-steroidal anti-inflammatory medications (NSAIDs). When the pain and inflammation subside, a physical therapy program will be prescribed to strengthen and improve range of motion of the shoulder.

However, in the event of severe or complex damage to the shoulder, or when the ligaments no longer provide stability with joint movement, surgical intervention may be necessary to restabilize the shoulder. A Bankart repair, also known as capsulolabral reconstruction, is a minimally invasive surgical procedure that involves the manipulation of the anterior shoulder capsule and the repair and reattachment of the damaged glenoid labrum. Dr. Matthew T. Provencher, orthopedic shoulder doctor, treats patients in Vail, Aspen, Colorado Springs, and the Denver, Colorado area who have experienced recurrent shoulder dislocations and are in need of a Bankart repair.

How is a Bankart repair performed?

Dr. Provencher favors the arthroscopic approach when performing a Bankart repair. A nerve block is administered prior to the procedure. When the patient is stable and in the correct position, Dr. Provencher creates small incisions surrounding the shoulder. A small camera (arthroscope) is inserted through a portal for Dr. Provencher to methodically examine the tendons, ligaments, and labrum of the glenohumeral joint. The injured area is identified, and the specialized surgical instruments are introduced to excise and remove the damaged tissues. When the repairs are complete, the remaining labrum and anterior shoulder capsule are fastened back into the correct anatomical position with special surgical anchors that are secured within the bone.

Although the arthroscopic technique is preferred by both patients and surgeons alike, a Bankart lesion may need to be repaired with open surgery. Dr. Provencher may recommend this surgical approach over an arthroscopic repair for patients that have experienced large bone loss from multiple dislocations or an unsuccessful shoulder reduction or recurrent after previous arthroscopic repair. The open surgical technique uses a slightly larger incision to visualize the entire shoulder as well as a tendon graft, either from the patient (autograft) or donor tissue (allograft), to generate new ligaments and cartilage.

What is the recovery period like after a Bankart repair?

The recovery period following a successful Bankart repair is determined by the surgical technique conducted by Dr. Provencher. While the minimally invasive arthroscopic approach does shorten the recovery time, the soft tissues still take the same amount of time to heal. Most patients regain functional mobility in approximately 6 to 12 weeks and can expect a return to normal daily and physical activities in 6 months. Patients in the Vail, Aspen, Colorado Springs, and the Denver, Colorado area can generally expect the following:

• The shoulder joint will be immobilized by a sling, or other device, immediately after surgery and remain immobile for 3 to 6 weeks.
• Pain and inflammation are managed with a combination of rest, ice pack application, and non-steroidal anti-inflammatory medications (NSAIDs).
• Heavy lifting and contact sports will need to be avoided for approximately 3 months.
• The key to a successful recovery following a Bankart repair is adhering to and completing the physical rehabilitation program designed by Dr. Provencher. The physical therapy program will begin approximately 4 to 8 weeks after surgery and will focus on improving shoulder range of motion and strength.

For more information on the Bankart repair technique, or to discuss your recurrent shoulder dislocation treatment options, please contact the office of Matthew T. Provencher, MD, orthopedic shoulder doctor at The Steadman Clinic, serving Vail, Aspen, Colorado Springs, and the Denver, Colorado area.