The glenohumeral joint, commonly known as the shoulder joint, is characterized by its ball and socket structure, where the head of the upper arm bone (humerus) connects with the shallow shoulder socket (glenoid cavity). To prevent dislocation, the shoulder socket relies on additional support provided by the labrum, a ring of cartilage encircling the socket. This labral structure enhances joint stability, facilitating a wide range of movements.
Labral tears, such as the Bankart tear, often occur following shoulder injuries, particularly dislocations. The Bankart tear specifically affects the inferior glenohumeral ligament of the labrum and is prevalent among younger individuals who experience shoulder dislocations. Such tears increase the risk of recurrent dislocations, especially in patients under 30 years old.
Diagnosis
Diagnosis of a Bankart tear involves a comprehensive assessment of medical history and a thorough physical examination of the shoulder. Further diagnostic imaging studies, including X-rays or MRI scans, may be recommended by your physician to confirm the diagnosis.
Treatment
In cases where conservative treatments like rest and immobilization fail to improve the condition or prevent recurrent dislocations, Bankart repair surgery becomes necessary.
Description of Procedure
Bankart repair surgery, often performed using minimally invasive arthroscopic techniques, involves making small incisions around the shoulder joint. An arthroscope, equipped with a camera and light source, is inserted through one of these incisions to provide a clear view of the joint’s interior on a monitor. Using specialized surgical instruments through the other incisions, your surgeon trims the edges of the glenoid cavity and reattaches the torn labrum to the socket using suture anchors. Compared to open techniques, arthroscopy minimizes disruption to surrounding shoulder structures and eliminates the need to detach and reattach the overlying shoulder muscle (subscapularis).
Post-operative Care
Following surgery, patients typically spend about an hour in the recovery room before beginning physical therapy the next day to enhance shoulder strength and range of motion. While light activities may be resumed as tolerated, heavier lifting should be avoided during the initial healing period. A sling may be worn for up to three weeks to limit shoulder movement.
Risks
Low-risk activities like jogging and swimming may be reintroduced 8 to 10 weeks post-surgery, with caution advised regarding contact sports.
Arthroscopic Bankart repair is generally considered safe, with fewer associated risks and a faster recovery compared to open procedures. However, potential complications may include infection, nerve or blood vessel injury, joint stiffness, and postoperative pain.