A Bankart repair is a surgical procedure designed to restore stability to the shoulder joint following a traumatic dislocation. It addresses structural damage that allows the “ball” of the joint to repeatedly slip out of the “socket.” The surgery reconstructs the damaged anatomy, securing the joint’s natural restraints to prevent future instability. This procedure is typically recommended when conservative treatments have failed to resolve chronic shoulder instability.
What Causes the Need for Bankart Repair
The shoulder is a highly mobile ball-and-socket joint where the head of the upper arm bone (humerus) rests within the shallow socket of the shoulder blade (glenoid). A ring of specialized cartilage, called the labrum, encircles the glenoid, deepening the socket and providing stability. The labrum is an attachment point for the joint capsule and the primary shoulder ligaments, which are the main static stabilizers.
The need for repair stems from a Bankart lesion, which results from a forceful, traumatic anterior shoulder dislocation. When the humerus is pushed forward and out of the socket, it tears the inferior labrum and attached ligaments from the front edge of the glenoid bone. This detachment loosens the ligaments, causing chronic instability and recurrent dislocations. If the dislocation chips bone from the glenoid rim, it is called a bony Bankart lesion, further compromising stability. Surgical repair re-anchors the torn tissues back to the bone to prevent continued instability.
How the Bankart Procedure is Performed
The goal of the Bankart procedure is to re-establish the structural integrity of the shoulder’s anterior stabilizing complex. The surgery involves reattaching the detached labrum and tightening the joint capsule. This reconstruction is typically performed using arthroscopy, a minimally invasive technique.
During arthroscopic repair, the surgeon uses a small camera and specialized instruments inserted through tiny incisions. The glenoid rim is prepared by roughening the bone surface to promote healing. Small, threaded suture anchors are then implanted into the glenoid bone.
Sutures attached to these anchors are passed through the torn labrum and joint capsule. The surgeon pulls the tissues back into their correct anatomical position against the prepared glenoid rim. Tying the sutures secures the labrum and tightens the capsule, restoring the shoulder’s natural tension.
An Open Bankart Repair may be necessary for complex injuries, such as significant glenoid bone loss or revisions of failed repairs. This technique uses a single, larger incision for direct visualization. Successful reattachment restores the shoulder’s static stability.
Navigating the Recovery Process
Recovery requires diligent patient compliance to ensure the repaired tissues heal properly. Immediately following surgery, the arm is immobilized in a sling for a prescribed period, typically three to six weeks, to protect the repair while the labrum re-heals to the bone. Pain management, involving ice and prescribed medication, is a focus during this initial protective phase.
Physical therapy (PT) usually begins within the first two weeks after surgery, starting with gentle, passive range-of-motion exercises. In this initial stage, the therapist moves the patient’s arm to prevent stiffness without engaging the shoulder muscles, which could strain the repair.
The mid-to-late phases of PT focus on progressive strengthening of the rotator cuff and surrounding muscles. This strengthening is important for dynamic stability, complementing the static stability achieved by the surgery. Patients generally resume light daily activities within six to eight weeks. Full return to high-demand activities, such as contact sports, usually requires four to six months.