Bankart Repair

When the shoulder dislocates forwards, the cartilage ring around the lower front edge of the socket (the labrum) and the joint capsule attached to it can tear away from the bone. This injury is called a Bankart lesion. The labrum deepens the socket and helps keep the head of the upper arm bone in place. When the tear does not heal, the shoulder starts to dislocate again and again or feels as if it might slip.

Who gets it?

A Bankart lesion is most often seen in young, active people after a first dislocation in contact sport or a fall with the arm raised. After a first dislocation at a young age, the chance of recurrence is high.

Symptoms

• Recurrent dislocations or partial dislocations
• A feeling of insecurity with the arm raised and turned outwards
• The shoulder slipping during sleep or sudden movements
• Avoiding certain sports and movements

Diagnosis

Shoulder stability is assessed with specific tests. MRI or MR arthrography shows the labral tear. If bone loss from the socket is suspected, CT is used to measure it. The amount of bone loss is one of the main factors that decide which procedure is used.

Arthroscopic Bankart repair

The operation is usually done under general anaesthesia with a regional nerve block. A camera and fine instruments are passed into the shoulder through a few small holes. The torn labrum and loose capsule are reattached to the rim of the socket with small suture anchors, restoring the depth of the socket and the tension of the capsule. Arthroscopy allows a detailed look inside the joint and treatment of any other lesions.

In patients with significant bone loss, soft tissue repair alone may not be enough. Bone block transfer procedures such as the Latarjet are then considered.

After surgery

• Weeks 0-4: Sling, hand, wrist and elbow exercises, controlled shoulder movement
• Weeks 4-12: Gradually increasing range of motion, starting muscle strengthening
• Months 3-6: Sport-specific strength and balance work, preparation for contact sport

The return to sport is decided by assessing shoulder strength, range of motion and confidence.

What is assessed before surgery?

Shoulder range of motion and muscle strength are assessed, and the number of dislocations and how they happened are recorded. Because the amount of bone loss decides the technique, CT measurements are reviewed carefully. For athletes, the timing of surgery is planned together around the season.

Frequently asked questions

Can my shoulder dislocate again after a Bankart repair?

The risk of dislocation drops considerably after repair but is not zero. Contact sport and stopping rehabilitation early can increase the risk.

How long is the sling worn?

Usually for a few weeks. The exact time depends on the extent of the repair.

Will I lose some movement?

With controlled physiotherapy, shoulder movement largely returns in most patients. Small limits at the end of the range tend to ease over time.

Bankart repair or Latarjet?

If there is no significant bone loss from the socket, arthroscopic Bankart repair is usually enough. With greater bone loss or many dislocations, a bone block transfer may be more suitable.

The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.