What is a Bankart Repair?

A Bankart repair is a surgical procedure used to treat shoulder instability, particularly caused by a Bankart lesion. A Bankart lesion occurs when the labrum (a ring of cartilage around the shoulder socket) is torn due to a shoulder dislocation. This injury compromises the stability of the shoulder joint, leading to recurrent dislocations or feelings of the shoulder “giving out.”

The procedure involves reattaching and repairing the torn labrum to the edge of the glenoid (socket of the shoulder joint), often along with repairing the associated ligaments.

Why is a Bankart Repair Performed?

Bankart repair is indicated in cases of:

1. Recurrent Shoulder Dislocations: Particularly in younger, active patients where the labrum has been damaged.
2. Bankart Lesion: A specific injury where the labrum is torn from the front (anterior) or, less commonly, the back (posterior) of the glenoid.
3. Shoulder Instability: Patients experiencing subluxation (partial dislocations) or feelings of looseness in the joint.
4. Traumatic Injury: Often following an anterior dislocation caused by trauma, such as a fall or sports injury.

What is a Bankart Lesion?

The Bankart lesion is a tear of the labrum and sometimes the inferior glenohumeral ligament, which helps hold the humeral head (ball of the joint) in the glenoid (socket). This injury is typically caused by traumatic shoulder dislocations and leads to:

• Loss of stability in the shoulder.
• Increased risk of repeat dislocations, especially in activities requiring overhead or throwing motions.

Types of Bankart Repair

1. Arthroscopic Bankart Repair:
   • Minimally invasive procedure using a camera (arthroscope) and small instruments.
   • Preferred due to shorter recovery times and less tissue damage.
2. Open Bankart Repair:
   • Traditional approach involving a larger incision.
   • Often reserved for complex cases or patients with significant instability.

Procedure Overview

Arthroscopic Bankart Repair:

1. Incision and Arthroscope Insertion: Small incisions are made, and a camera is inserted to view the joint.
2. Debridement: Damaged tissue and debris are cleaned from the shoulder joint.
3. Anchor Placement: Small anchors with sutures are placed into the glenoid bone.
4. Labrum Repair: The torn labrum is reattached to the glenoid using the sutures.
5. Closure: The incisions are closed, and a dressing is applied.

Open Bankart Repair:

• Involves a direct incision over the shoulder joint.
• Allows the surgeon to directly visualize and repair the labrum.
• May include tightening of surrounding ligaments.

Benefits of Bankart Repair

• Restores Stability: Reduces the risk of future dislocations.
• Minimally Invasive (in arthroscopic cases): Shorter recovery time and less pain.
• Durable Results: High success rates for active and athletic patients.

Recovery and Rehabilitation

Post-Surgery Recovery:

• Sling Usage: The arm is immobilized in a sling for 4-6 weeks.
• Pain Management: Includes medications and ice packs.

Physical Therapy:

Recovery typically progresses through three stages:

1. Phase 1 (0-6 weeks):
   • Passive range-of-motion exercises to prevent stiffness.
   • No active shoulder use.
2. Phase 2 (6-12 weeks):
   • Gradual introduction of active range-of-motion exercises.
   • Light strengthening exercises.
3. Phase 3 (3-6 months):
   • Advanced strengthening and proprioception exercises.
   • Return to sports or strenuous activities after 6 months.

Risks and Complications

While Bankart repair is generally safe, potential risks include:

• Infection: Rare but possible at the surgical site.
• Stiffness: Reduced range of motion in some cases.
• Recurrent Instability: A small percentage may experience re-dislocations.
• Nerve Injury: Rare damage to surrounding nerves.

Success Rates

Bankart repair has a 90-95% success rate for restoring shoulder stability and preventing recurrent dislocations. Factors that influence outcomes include:

• Patient age (younger patients tend to have higher recurrence rates).
• Level of physical activity (athletes may have slightly higher risks).
• Extent of labral damage or associated injuries (e.g., glenoid bone loss).

Bankart Repair vs. Latarjet Procedure

Feature	Bankart Repair	Latarjet Procedure
Indication	Soft-tissue labral tear	Significant bone loss or failed repairs
Method	Soft-tissue repair	Bone transfer for stability
Recovery Time	4-6 months	4-6 months
Preferred in Athletes	Effective for most athletes	Better for contact or collision sports

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Who is a Candidate for Bankart Repair?

Bankart repair is ideal for:

• Young, active individuals with recurrent dislocations.
• Patients with soft-tissue-only injuries (no significant bone loss).
• Athletes participating in overhead or contact sports.

Conclusion

A Bankart repair is a highly effective solution for restoring shoulder stability after a labral tear. Whether performed arthroscopically or as an open procedure, it offers long-lasting relief from recurrent dislocations, enabling patients to return to daily activities and sports with confidence.