A Bankart repair is a common surgical procedure performed to stabilize the shoulder joint following a traumatic dislocation. This intervention specifically addresses damage to the soft tissues that help keep the arm bone centered in the shoulder socket. By fixing the damaged anatomy, the procedure significantly reduces the risk of future dislocations.
What is a Bankart Lesion?
A Bankart lesion is a specific injury to the shoulder’s labrum, a ring of cartilage that acts like a bumper around the edge of the glenoid, or shoulder socket. This fibrocartilaginous structure deepens the shallow socket and serves as the attachment point for the shoulder’s stabilizing ligaments. The injury typically occurs when the shoulder dislocates, which is often caused by a sudden, forceful movement where the arm is put into an overhead or vulnerable position.
During a dislocation, the head of the humerus, or upper arm bone, is violently pushed forward and out of the socket. This action tears the front and bottom portion of the labrum, known as the anteroinferior labrum, away from the bone of the glenoid. The detachment of the labrum and the attached ligaments compromises the shoulder’s stability, often leading to a sensation of the joint “slipping” or feeling loose.
The Surgical Repair Process
The central objective of a Bankart repair is to reattach the torn labrum and joint capsule back to the rim of the glenoid bone. Surgeons typically utilize an arthroscopic approach, which is a minimally invasive technique involving small incisions and specialized instruments. This method has become the standard treatment for anterior shoulder instability when there is no significant bone loss on the glenoid.
During an arthroscopic repair, a camera is inserted into the joint. The torn labrum is meticulously mobilized and prepared, and the bone surface of the glenoid neck is roughened to promote healing and tissue reattachment. The actual repair is performed using small, specialized devices called suture anchors.
These anchors, which may be made of absorbable material or metal, are placed directly into the glenoid bone along the tear site. Strong sutures are pre-loaded onto the anchors, and the surgeon uses these threads to pass through the detached labrum and capsule. By tightening the sutures, the surgeon effectively pulls the torn soft tissue complex back into its correct anatomical position against the bone.
Multiple anchors are typically placed to secure the entire length of the tear, recreating the labral bumper and tensioning the ligaments to stabilize the joint. While arthroscopy is the most common method, an open surgery is sometimes reserved for more complex cases, such as those involving significant bone fragments broken off the glenoid or situations where other repairs have failed.
Navigating Post-Operative Rehabilitation
Recovery from a Bankart repair is a structured, multi-phase process. Immediately following the procedure, the shoulder is immobilized in a sling, which must be worn consistently for several weeks, often up to six weeks, to protect the delicate repair. The patient only performs gentle exercises for the hand, wrist, and elbow to prevent stiffness in those areas.
The next phase introduces cautious movement, starting with passive range of motion exercises where a physical therapist or a device moves the arm without the patient’s muscle activation. The physical therapy program then progresses to active-assisted range of motion, where the patient begins to use their own muscles to move the arm, often with the assistance of a cane or the non-operative arm.
Strengthening exercises, which initially focus on the rotator cuff and scapular muscles, are typically introduced around six to twelve weeks post-operation. The goal of this period is to rebuild muscle strength and endurance, enhancing the dynamic stability of the shoulder joint. Patients should avoid heavy weight training or manual labor until at least three months after surgery. The full return to high-demand activities, like contact sports, is generally permitted around four to six months, once the surgeon confirms complete healing.