Bankart Repair

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Bankart Repair

Bankart repair is a surgical procedure designed to treat shoulder instability caused by a Bankart lesion, which is a tear or injury to the labrum (the cartilage that lines the shoulder socket) and is typically associated with shoulder dislocations. When the labrum is torn, the ball-and-socket joint of the shoulder becomes less stable, increasing the likelihood of further dislocations. The Bankart lesion often results from an acute trauma or repetitive dislocation of the shoulder, commonly seen in athletes involved in contact sports or those who experience sudden forceful motions of the shoulder. Bankart repair aims to restore the stability of the shoulder joint by reattaching the torn labrum to its original position, allowing the shoulder to regain its natural stability and function.

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When is Bankart Repair Recommended?

Bankart repair is recommended for individuals who have experienced recurrent shoulder dislocations or subluxations (partial dislocations) that cause pain, weakness, or instability in the shoulder. It is particularly beneficial for younger, active individuals who participate in sports or physical activities and wish to return to their regular routines. The procedure is most effective when there is a significant tear of the labrum that cannot be managed conservatively. In addition, a Bankart repair is often advised when conservative treatments, such as physical therapy or shoulder bracing, fail to restore stability. Diagnostic imaging, such as MRI or CT scans, is used to confirm the Bankart lesion and assess the severity of the injury, guiding the decision to undergo surgery.

Preparing for Bankart Repair

Preparation for Bankart repair involves a thorough assessment by an orthopedic surgeon, including diagnostic imaging and a review of the patient's medical history. Pre-operative counseling helps patients understand the procedure, expected outcomes, and the importance of post-surgical rehabilitation. It is essential to stop certain medications that may interfere with the healing process, such as blood thinners. Patients are also advised to refrain from eating or drinking for several hours before surgery. Physical therapy may be recommended prior to surgery to improve the strength and mobility of the shoulder, which can help reduce recovery time post-surgery. Additionally, arrangements for post-operative care, such as wearing a shoulder brace or sling, should be made in advance to ensure a smooth recovery process.

The Surgical Procedure

Bankart repair is typically performed using arthroscopic (minimally invasive) techniques, although open surgery may be necessary in some cases. The procedure is performed under general anesthesia and typically takes 1-2 hours. Small incisions are made around the shoulder, and a tiny camera (arthroscope) is inserted to visualize the tear in the labrum. Specialized instruments are then used to reattach the torn labrum to the shoulder socket using sutures or anchors. In some cases, bone grafts or other supportive procedures may be used to enhance the repair, particularly if there is bone damage to the shoulder socket (glenoid). Once the labrum is securely reattached, the shoulder joint is tested for stability, and the incisions are closed with sutures or staples. A sterile dressing is applied, and the patient is moved to recovery for monitoring.

Recovery and Rehabilitation

Recovery from Bankart repair typically involves a structured rehabilitation process to restore the strength, flexibility, and stability of the shoulder. The initial recovery phase focuses on pain management, controlling swelling, and preventing complications such as infection. Patients are usually required to wear a sling or brace for several weeks to immobilize the shoulder and allow the labrum to heal. Physical therapy begins shortly after surgery, starting with gentle range-of-motion exercises and gradually progressing to strengthening exercises as healing progresses. Most patients can resume light daily activities within 3-6 weeks, while sports or high-demand activities are typically resumed after 4-6 months, depending on individual recovery and rehabilitation efforts. Full recovery and return to high-level athletic activities may take up to 9-12 months.

Benefits and Risks

Bankart repair offers several key benefits, including the restoration of shoulder stability, reduction of the risk of further dislocations, and the ability to return to normal daily activities and sports. The procedure is highly effective in preventing future shoulder instability, particularly in younger, active individuals. Additionally, arthroscopic techniques minimize the invasiveness of the surgery, leading to shorter recovery times compared to open surgery. However, like any surgical procedure, Bankart repair carries risks such as infection, nerve injury, stiffness, re-tearing of the labrum, and difficulty regaining full range of motion. Adherence to post-operative rehabilitation protocols, including the use of a sling, physical therapy, and activity restrictions, is crucial to ensure optimal outcomes and reduce the likelihood of complications.