When do you Need a Bankart Repair?

By  aenriquez  published  December 17, 2017

Painful Shoulder InjuryA Bankart lesion is a common shoulder injury. This type of shoulder injury often requires Bankart repair. This lesion is when the anterior and inferior portion of the labrum (band of cartilage) is torn away from the glenoid (portion of the joint socket. Bankart repair recovery ranges from six to nine weeks, and the procedure can be extensive, depending on the extent of the injury.

The shoulder joint is a combination of many joints that work together. The glenohumeral joint is where the humerus (upper arm bone) attaches to the scapula (shoulder blade) body. The area where the scapula meets the humerus is called the glenoid fossa. Along with this structure is the labrum, which is a tough band of cartilage. The role of the labrum is to deepen the socket to allow greater congruence between these structures.

 

Bankart Repair Success Rate

A Bankart lesion often occurs along with anterior shoulder dislocation. The shoulder may be continuously moved forward or anteriorly. The Bankart lesion can lead to further shoulder joint damage or injury to other areas of the shoulder. Bankart lesion repair is a surgery used to reconnect the torn labrum to the glenoid fossa, which repairs and stabilizes the joint to prevent further dislocations.

The most common surgical technique for the treatment of anterior shoulder instability is the arthroscopic Bankart repair or the open repair method. In a study evaluating the outcomes of these procedures, researchers reviewed 28 clinical trials. They also reviewed outcome measures, pain scores, dislocation rate, and other problems. The estimated re-dislocation rate was 15% following arthroscopic repair and only 7% following the open Bankart repair.

 

Bankart Repair Recovery

The rehabilitation process following a Bankart repair begins almost immediately. Within the first few days after surgery, passive range of motion starts through physical therapy. The physical therapist and doctor discuss what moves and measures to take for rapid recovery. A sling is only prescribed for use during showering and dressing changes. No internal rotation is allowed for several weeks. Other therapies used for pain control are massage and electrical stimulation.

For the first four weeks after the Bankart repair, the therapist focuses on helping you regain as much range of motion as possible. During this time, the shoulder strength will also improve and shoulder pain should decrease. After four weeks, the focus is on regaining shoulder strength and function. The patient must continue to work with the physical therapist to regain full function and range of motion of the shoulder.

 

Bankart Repair Protocol

Regardless of how the labrum was torn, the surgeon will work with you to decide on the best possible treatment. For many patients, Bankart tears are successfully treated with anti-inflammatory measures, rest, physical therapy, and activity modification. When conservative measures fail to restore function, the doctor may suggest Bankart repair. Labral repair involves re-anchoring, suturing, and/or trimming away torn pieces of cartilage. The procedure is most often performed arthroscopically, and most patients go home the same day as the surgery.

 

The time it takes to recover after a Bankart repair varies from person-to-person. It typically takes 4-6 months for full recovery. For some patients, it can take a full year to full recovery. People with desk jobs must take1-2 weeks off from work. For those who lift and do labor type jobs, plan on being out of work for up to 6 months. Postoperatively, you will see the doctor in 5-10 days, and physical therapy usually begins soon after your procedure. You can use ice 3-6 times each day for 20-minute intervals for pain and swelling and must wear a sling for the first 2 weeks.

 

Resources
Rollick NC, Ono Y, Kurji HM, et al. (2017). Long-term outcomes of the Bankart and Latarjet repairs: a systematic review. Ortho Surg, 8, 97-105.
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