Bankart Repair Surgery
When a shoulder dislocates forward, the ball shears the labrum away from the front rim of the socket on its way out. That injury pattern is called a Bankart lesion, and it is the reason a shoulder that has dislocated once is so much more likely to dislocate again. A Bankart repair reattaches that torn rim.
A Bankart repair is one of the procedures arthroscopic volume most directly improves, and Steven Struhl, MD has performed more than 5,000 arthroscopic procedures since 1991. He is board certified in orthopedic surgery and separately in sports medicine and arthroscopic surgery, completed his sports medicine fellowship at Penn State University, and is a member of the Arthroscopy Association of North America.
What a Bankart Lesion Is
The labrum deepens the shallow shoulder socket and anchors the ligaments that keep the ball centered. When it tears away from the front rim, the socket effectively becomes shallower and the front restraint is gone, so the shoulder slips more easily in the same direction it went the first time.
- Soft Tissue Bankart: the labrum detaches from the socket rim with the bone intact.
- Bony Bankart: a fragment of the socket rim breaks away with the labrum still attached.
- Associated Hill Sachs Lesion: an impression fracture on the back of the humeral head.
- Capsular Stretching: the joint capsule stretches during dislocation and contributes to looseness.
The bony version matters because it changes the operation. Enough lost socket bone makes a soft tissue repair unreliable, and a bone restoring procedure becomes the better choice.
Who Needs a Bankart Repair
Age at first dislocation predicts recurrence better than almost any other factor.
- Young Athletes: patients under twenty five have high recurrence rates after a first dislocation.
- Recurrent Dislocation: a shoulder that has come out more than once rarely settles on its own.
- Contact Sport Demands: collision athletes place the shoulder in vulnerable positions repeatedly.
- Persistent Apprehension: an inability to trust the shoulder overhead even between dislocations.
How the Repair Is Performed
The procedure is arthroscopic in the great majority of cases. Through several small incisions, the torn labrum is mobilized off the socket neck, the bone edge is prepared so the tissue has a surface to heal to, and suture anchors placed into the rim pull the labrum back into anatomic position. The stretched capsule is tightened at the same time, since leaving it loose undermines the repair.
Recovery After Bankart Repair
- Weeks One To Six: a sling protects the repair, with the arm kept out of external rotation.
- Weeks Six To Twelve: supervised motion is restored gradually, external rotation last.
- Months Three To Five: strengthening of the rotator cuff and the scapular stabilizers.
- Months Five To Six: return to contact sport, once the shoulder controls itself under load.
The external rotation restriction in the first six weeks is the part patients find frustrating and the part that protects the result, since that position pulls directly on the repaired tissue.
Schedule a Shoulder Evaluation in New York City
A shoulder that has dislocated once and a shoulder that has dislocated five times are different problems, and both benefit from imaging that shows what the labrum and the socket bone actually look like before a repair is planned. Dr. Struhl evaluates shoulder instability at his Manhattan and White Plains offices. Contact the practice to schedule an appointment.
