Arthroscopic Bankart

What is arthroscopic Bankart?

Shoulder instability is a problem characterized by dislocation or subluxation of the shoulder and frequently affects young patients and sportspeople.

What situations of instability require surgery?

Surgical treatment of shoulder instability is an option for cases of recurrent instability despite adequate initial conservative treatment. There is no set number of episodes of dislocation or subluxation after which surgery should be considered. In very specific situations, surgery may be indicated after a first episode of dislocation. Evaluation by an orthopedic surgeon specializing in shoulder surgery will help to understand the treatment options and the best solution available.

What is a Bankart lesion?

A Bankart lesion is defined as a tear in the fibrocartilage that surrounds the articular surface of the glenoid in the shoulder blade. This fibrocartilage acts as a seal that increases the stability of the humeral head and prevents it from moving excessively, leading to dislocation or subluxation of the shoulder. A Bankart lesion is a typical sequela of instability and may be accompanied by bone or cartilage loss that increases the likelihood of dislocation.

What is arthroscopic Bankart repair (Arthroscopic Bankart)?

Bankart repair involves attaching the injured fibrocartilage fragment back to its insertion in the glenoid. Through a small incision, a camera is introduced into the joint, allowing visualization of the lesion. Other small incisions allow the insertion of instruments for repairing the Bankart lesion, using small anchors and high-strength sutures. This procedure restores the normal anatomy of the joint and increases the stability of the shoulder.

What are the advantages of Arthroscopic Bankart repair?

This minimally invasive method allows excellent visualization of the joint, without the need to damage other muscles and tendons as can occur with conventional surgery. In this way, post-operative pain is minimized and the quality of the fixation can dictate a faster recovery. The recurrence rate appears to be equivalent, given the development of materials used specifically for arthroscopic surgery. Cosmetically, the scars are approximately 5 mm and are almost imperceptible, unlike the conventional technique which results in a more extensive scar.

What to expect after an Arthroscopic Bankart?

Arthroscopic Bankart surgery takes approximately 1 hour and can be performed on an outpatient basis (admission and discharge on the same day), or with an overnight stay and discharge the following day. After surgery, immobilization of the arm is recommended for approximately 2 weeks. Mobilization exercises are started on the first postoperative day and, at the end of the immobilization period, rehabilitation with physiotherapy begins for approximately 3-4 months.

When can I return to sports after an arthroscopic Bankart repair?

Reintegration into sport depends on several factors, including the type of sport (e.g. contact sports or throwing), and near-normal shoulder function is expected from 3 months post-operatively. However, to allow adequate healing and reduce the likelihood of recurrence of instability, a 6-month period may be appropriate for high-risk sports.