Shoulder instability is a condition in which the shoulder joint is prone to repeated dislocation, either partial or complete. This most often
develops after a traumatic injury to the shoulder, or from overuse of naturally loose ligaments that do not hold the “ball” of the shoulder joint—the head of the humerus, the upper arm bone–tightly in its socket. Treatment for shoulder instability usually begins with physical therapy and other conservative measures, but in some cases surgical treatment may be necessary.
A Bankart repair is a surgical treatment commonly used for shoulders that are prone to dislocation. In this procedure, the torn labrum—connective tissue within the joint, which forms part of the socket holding the head of the humerus—and loose ligaments are reattached to the bone with suture anchors.
In this blog, Dr. Francis Mendoza will explain what is involved in a Bankart repair for shoulder instability.
What are the causes of a Bankart repair?
A Bankart lesion is a specific type of shoulder injury that occurs when the labrum of the shoulder joint is torn. This is very common with shoulder dislocations, and often contributes to shoulder instability. When a person sustains a shoulder dislocation, the labrum often tears as the shoulder pops out of joint. Specifically, the tear occurs in the inferior glenohumeral ligament, which is part of the labrum. When this ligament is torn, the injury is called a Bankart lesion.
What are the symptoms of shoulder instability?
You may be suffering from shoulder instability if you have any of the following symptoms:
- The joint feels “loose” or unstable
- You have repeated dislocations of the shoulder joint
- Your shoulder “catches” when you move the joint
- Aching in the shoulder
- A feeling as if the shoulder may dislocate again
What’s involved in a Bankart repair for shoulder instability?
A Bankart repair involves repairing the part of the labrum that is torn or over-stretched deep within the shoulder joint. The goal of the procedure is to reconnect the torn labrum to the glenoid fossa, which stabilizes the joint and prevents it from continuing to dislocate. It can be performed either arthroscopically or by an open procedure.
In the open surgery version of Bankart repair, general anesthesia is used and the patient is placed in a chair inclined to a 30-degree angle. The arm hangs free over the edge of the operating table and a bag is placed under the center of the shoulder blade to push it forward. Open surgery uses a larger incision than arthroscopic surgery and requires a longer recovery time.
When the procedure is performed arthroscopically, the surgeon uses and endoscope inserted directly into the joint through a small incision. The endoscope is a small instrument, which is the size of a pen, consisting of a tube outfitted with a miniature video camera and a light. This transmits video of the interior of the joint directly to a video monitor.
Using another small “keyhole” incision to allow access for surgical tools, the detached part of the labrum and the associated ligaments are reattached to bone along the rim of the glenohumeral cavity. This is guided by the video image transmitted by the endoscope, and is done with little disturbance of other shoulder structures and without detaching and reconnecting the overlying shoulder muscle.
Looking for a Bankart repair in the NYC area?
Dr. Mendoza is a fellowship-trained Manhattan shoulder specialist dedicated to treating shoulder instability with personalized treatment plans for each patient. Dr. Mendoza has served as the Director of Shoulder and Elbow Surgery at Lenox Hill Hospital. If you’re suffering from the symptoms of shoulder instability, schedule an appointment with Dr. Mendoza today to have your condition evaluated.