What is a Bankart Repair?

The glenoid labrum is a fibrocartilage rim surrounding the edge of the glenoid fossa (shoulder socket). The shoulder labrum tear can occur in different ways. When a patient’s shoulder is dislocated, the anterior (front) portion of the labrum is often torn. This is called a Bankart tear or lesion, and it is the most common form of ligament injury to the shoulder.  Many of these patients will go on to experience recurring shoulder dislocation.  This will have a significant effect on the ability to participate in sport and sometimes also their work.

Recent technical advances combined with improvements in implant choice and suture material this arthroscopic shoulder surgery the procedure of choice. Current arthroscopic techniques are associated with failure rates of 5% to 10%, comparable to open procedures.

Advantages

The advantages of an arthroscopic shoulder surgery include less surgical morbidity, less postoperative pain, improved cosmesis and an easier, if not shorter, rehabilitation. Also, the anatomy can be better visualized at the time of surgery and if the tear is more extensive, particularly if it extends into the posterior part of the shoulder the arthroscopic procedure allows for this to be repaired at the same time.

Procedure
The goal of the procedure is to re-attach and tighten the torn labrum and ligaments of the shoulder. To do so, the surgeon inserts an arthroscope into a small incision and uses sutures and small bone anchors to secure the ligaments firmly in place. It is performed under a general anaesthetic and generally takes about an hour. The patient will be in the operating theatre complex for several hours as they need to be prepared for anaesthesia and then will need to wake up from the anaesthetic. Usually, an overnight stay is recommended post surgery.

Recovery

Following the procedure, the patient will be wearing a sling with a body belt. This may be a standard sling or an External Rotation sling, depending on the procedure performed.  The sling should be worn at night and when out and about for 3 weeks. The patient will then wean off the sling with the aid of a physiotherapist over the next 3 weeks. 

A nerve block is usually used during the surgery. This means that immediately after the operation the shoulder and arm often feel completely numb. This may last for a few hours. After this, the patient may experience soreness in their shoulder. Treatment for shoulder pain would include administration of painkillers during the hospital stay. These can be continued after they are discharged. Ice packs may also help reduce pain.

This operation is usually done through two or three 5mm puncture wounds. There will be no stitches, only small sticking plaster strips over the wounds. These should be kept dry until healed. This usually takes 5 to 7 days.

For the first three weeks most activities of daily living for example feeding, dressing, cooking etc must be carried out using the un-operated arm. The patient will not be able to drive for a minimum of 6 weeks. The surgeon will confirm when the patient may begin.