Open Bankart Repair

Ideal candidates for Open Bankart Repair are individuals who have experienced repeated shoulder dislocations resulting in a Bankart lesion, leading to ongoing shoulder instability. This procedure might be chosen over the arthroscopic approach in cases of high risk athletes, severe labrum injuries, bony lesions, or failed previous arthroscopic repairs.

Open Bankart Repair surgery is performed under general anesthesia and typically includes the following steps: An incision is made over the front of the shoulder joint. The chest and shoulder muscles and tissues will be carefully moved aside to expose the shoulder joint and identify the labrum tear. The labrum is then reattached to the glenoid using sutures. This is achieved by drilling small holes into the edge of the glenoid and tying the labrum back into its anatomical position. In addition to fixing the labrum, the capsule surrounding the joint is then pulled up and “pleated” to tighten the joint to reduce the chance of it slipping out again.

Recovery from Open Bankart Repair is similar to that of the arthroscopic approach. Patients can typically return to one handed light-duty work within two weeks. Full recovery and a return to high-demand activities or sports may take up to six months or longer.

After the surgery, you will be monitored in a recovery room until the anesthesia wears off and you are able to go home. You can expect your shoulder to be immobilized in a sling for several weeks to protect the repair. Pain medications will be provided to manage any postoperative discomfort.

Post-surgery physical therapy is vital in recovery and follows a similar three-stage plan as the arthroscopic approach:

• Early Stage (Weeks 1-6): The main goals are to reduce inflammation, manage pain, and gradually regain passive range of motion in the shoulder.
• Middle Stage (Weeks 6-12): As your shoulder heals, the focus will be on 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.

All surgical procedures carry some risks. For Open Bankart Repair, these include:

• Infection: Occurs in less than 1% of patients. Antibiotics are typically administered before surgery to minimize this risk.
• Persistent instability or recurrent dislocation: Despite a successful repair, a small percentage of patients (approximately 5-10%) may experience continued instability or dislocation.
• Nerve damage: Though rare, nerve damage can result in temporary or permanent numbness, tingling, or weakness in the arm.
• Stiffness or loss of motion: Some patients may experience decreased range of motion or stiffness post-surgery, but this often improves with physical therapy.
• Pain: Despite successful repair, some patients may still experience pain in the shoulder. Also, due to the damage that was already done with the prior dislocations, you may be at a higher risk for arthritis.

If your shoulder surgeon Dr. Mayo recommends Open Bankart Repair and you choose not to undergo surgery, there are potential risks:

• Recurrent dislocation: Without repair, your shoulder may continue to dislocate, potentially causing further damage to the shoulder joint.
• Joint degeneration: Repeated dislocations and ongoing instability can lead to wear and tear of the shoulder joint, potentially causing osteoarthritis in the long term.
• Limited function: Persistent instability can impact your ability to perform daily activities and participate in sports or physical hobbies.