Arthroscopic Bankart Repair

Ideal candidates for an Arthroscopic Bankart Repair are individuals who have experienced shoulder dislocations or shifting resulting in a labrum tear or bankart lesion, who have ongoing shoulder instability or pain. These individuals often report sensations of the shoulder “giving way” or repeated dislocations. Athletes involved in contact sports or activities that require overhead motions are common candidates for this procedure as well. Younger patients who dislocate their shoulder have close to a 100% chance of re-dislocation if it is not surgically repaired.

Arthroscopic Bankart Repair is a minimally invasive procedure performed under general anesthesia where you are completely asleep. Your shoulder surgeon Dr. Ben Mayo makes several small incisions around your shoulder and a small camera is inserted that allows us to view the inside of the shoulder joint on a screen. The damage to the labrum and other structures such as the cartilage will be assessed and pictures will be taken. Using special instruments, the labrum is freed up so it can be pulled back to where it belongs on the shoulder socket (glenoid). Small anchors made of plastic or suture are then drilled into the bone, and sutures are used to reattach the labrum and capsule to the correct spot. If you have a significant Hill-Sachs lesion, or dent in the back of the humeral head, a Remplissage procedure may be performed. This involves stitching the shoulder’s posterior capsule and a portion of the infraspinatus muscle into the defect, effectively “filling” the dent and reducing the risk of future dislocations.

Recovery from Arthroscopic Bankart Repair varies among individuals and depends on the extent of the shoulder damage and the specific surgical procedure. Typically, patients can return to light-duty work or school within a week or two. However, return to heavy lifting or sports activities usually several months. Full recovery often occurs within four to six months post-surgery.

Once you wake up from surgery you will be monitored for an hour or two before you are discharged home the same day. You can expect your shoulder to be immobilized in a sling for about 1 month to protect the repair. Pain medications will be provided to manage any postoperative discomfort.

Physical therapy is essential in the recovery process and typically involves three stages:

• Early Stage (Weeks 1-6): The main goals are to reduce inflammation, manage pain, and gradually regain some passive range of motion in the shoulder.
• Middle Stage (Weeks 6-12): As your shoulder heals, the focus shifts towards active range-of-motion exercises and gentle strengthening exercises.
• Late Stage (Weeks 12 and beyond): The final stage involves more advanced strengthening exercises and activities aimed at returning you to your pre-injury level of activity.

While Arthroscopic Bankart Repair is generally safe, all surgeries come with potential risks. However, these complications are rare:

• Infection: Occurs in less than 1% of patients. Antibiotics are given before surgery to minimize this risk.
• Persistent instability or recurrent dislocation: Despite successful repair, some patients (approximately 5-10%) may experience continued instability or dislocation.
• Nerve damage: Rare but can result in temporary or permanent numbness, tingling, or weakness in the arm.
• Stiffness: Some patients may experience decreased range of motion or stiffness post-surgery, but this often improves with physical therapy. For patients who require a high level of motion such as baseball pitchers, this may make it very difficult to return to previous level of play.
• Pain: Some patients may continue to have pain after surgery.

If it is recommended to have Arthroscopic Bankart Repair and you choose not to undergo surgery, there are potential risks:

• Recurrent dislocation: Without repair, your shoulder may continue to dislocate, which can cause further damage to the shoulder joint. In younger patients under 20 years old, there is a near 100% chance of re-dislocation.
• Joint degeneration: Repeated dislocations and ongoing instability can lead to wear and tear of the shoulder joint, potentially causing osteoarthritis in the long term. Additionally, if the shoulder remains unstable and has recurrent dislocations or subluxations, there is a risk for further damage to the underlying bony structures in the shoulder which makes future surgeries potentially more complicated and involved.
• Limited function: Persistent instability can impact your ability to perform daily activities and participate in sports or physical hobbies.