bankart-repair

What is a Bankart lesion?

Shoulder instability and recurrent shoulder dislocations are the cause of a lot of visits to Dee Why physiotherapists and shoulder surgeons.

The root cause of shoulder instability can be a number of different conditions, and the most commonly injured structure following a shoulder dislocation is the anterior labrum, AKA Bankart lesion.[1]

What is a bankart lesion?

The Bankart lesion is named after English orthopaedic surgeon Arthur Sydney Blundell Bankart.

The shoulder socket, or glenoid is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilise the joint. During anterior shoulder dislocations (when the humeral head is displaced towards the front) the labrum may be torn. Labral tears and other lesions are also common in athletes and workers that use repetitive overhead activities.

After a dislocation in young patients, instability recurrence rate has been reported to be up to 90%.[2]

Occasionally a bony piece of the socket will fracture off with the labrum; this is imaginatively called a “bony Bankart” lesion.

Symptoms of a Bankart lesion can include:

  • Pain when reaching overhead, to put the seatbelt on and daily activities.
  • Instability and weakness that causes apprehension about moving the shoulder into certain positions away from the body. Low energy movements, like rolling over in bed commonly mentioned as times when their shoulders can ‘slip’.
  • Limited range of motion.
  • Grinding, catching, locking in place, or popping

Bankart lesions are commonly treated using conservative methods such as rest, immobilisation, and a physiotherapy program, particularly in older patients.

However, many cases require surgery to reattach the torn labrum to the socket of the shoulder performed through arthroscopy.

As with any surgical procedure, there are risks associated with arthroscopic Bankart repair that may include:

  • Bleeding
  • Infection
  • Blood clots
  • Shoulder stiffness
  • Blood vessel or nerve injury
  • Post traumatic arthritis.

Early physio rehab goals after bankart repair surgery

After arthroscopic Bankart repair, you will generally be required to keep your arm immobilized in a sling for approximately one month but physio will usually start within the week.

Once you have had surgery to repair your bankart lesion, Early goals for your surgery rehab will be to:

  • Protect surgical repair
  • Reduce swelling, minimise pain
  • Maintain range of motion in the elbow, hand and wrist
  • Minimise muscle inhibition
  • Educate you on your injury and ways to minimise recurrence

After surgery it is important to

  • Not overstress healing tissue
  • Gradually return to full functional activities
  • Do your rehab exercises
  • Listen to your physio

Be sure to follow your bespoke treatment plan. Although recovering from shoulder surgery can be a slow process, your commitment to physiotherapy is the most important factor in returning to all the activities you enjoy without pain or fear of instability.

[1] Bankart ASB. Recurrent or habitual dislocation of the shoulder- joint. Br Med J. 1923;2(3285):1132-1133. doi:10.1136/bmj.2.3285.1132.

[2] Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations. Arthroscopic and physical examination findings in first- time, traumatic anterior dislocations. Am J Sports Med. 1997;25(3):306-311. doi:10.1177/036354659702500306.

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