The shoulder joint (glenohumeral joint) is a ball and socket joint, where the head of the upper arm bone (humerus) attaches to the shoulder socket (glenoid cavity). The shoulder socket is extremely shallow and therefore needs additional support to keep the shoulder bones from dislocating. The labrum, a cuff of cartilage that encircles the shoulder socket, helps serve this purpose by forming a cup for the humeral head to move within. It provides stability to the joint, enabling a wide range of movements.
The labrum can sometimes tear during a shoulder injury. A specific type of labral tear that occurs when the shoulder dislocates is called a Bankart tear. This is a tear to a part of the labrum called the inferior glenohumeral ligament and is common in younger patients who sustain a dislocation of the shoulder. A Bankart tear makes the shoulder prone to repeat dislocation in patients under 30 years of age.
Your physician will ask about your medical history and perform a thorough physical examination of your shoulder. Your doctor may recommend an additional X-ray or an MRI.
Conservative treatment measures for a bankart tear include rest and immobilization with a sling followed by physical therapy.
Bankart repair surgery is indicated for a bankart tear, when conservative treatment measures do not improve the condition, but instead results in repeated shoulder joint dislocation.
During an arthroscopic Bankart procedure, your surgeon makes a few small incisions over your shoulder joint. An arthroscope, a slender tubular device attached with a light and a small video camera at the end, is inserted through one of the incisions into your shoulder joint. The video camera transmits the image of the inside of your shoulder joint onto a television monitor for your surgeon to view. Your surgeon then uses small surgical instruments through the other tiny incisions to trim the edges of your glenoid cavity. Suture anchors are then inserted to reattach the detached labrum to the glenoid. The tiny incisions are then closed and covered with a bandage.
Arthroscopy causes minimal disruption to the other shoulder structures and does not require your surgeon to detach and reattach the overlying shoulder muscle (subscapularis) as with the open technique.
Bankart repair is a relatively safe procedure, but as with any surgical procedure, potential risks and complications may occur. Some of the potential risks include:
Bankart repair is a reliable surgical treatment with good clinical outcome. It can reduce your rate of recurrent shoulder instability and significantly improve your post-operative shoulder motion and quality of life.