The shoulder is one of the largest and most complex joints in the human body. The humerus (upper arm bone) and the scapula (shoulder blade) join to form the shoulder joint. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons.
The labrum is a cartilage present in the shoulder joint. It is a firm ring of tissue around the socket of the shoulder. A labral tear causes shoulder pain and instability. These tears result when there is a shoulder injury such as a fall on an outstretched hand. Overuse injuries also can cause labrum tears.
A Bankart lesion is a shoulder injury that occurs due to a labrum tear causing instability and recurrent dislocations of the shoulder joint.
Arthroscopic Bankart repair is a minimally invasive surgical procedure performed to reattach and tighten the detached labrum within the shoulder joint.
Indications
- Shoulder dislocations
- Torn labrum
- Recurrent shoulder instability
Surgical procedure
The objective of the surgery is to restore the normal anatomy of the shoulder by repair and reattachment of the torn labrum.
Bankart repair can be performed surgically with an arthroscopic technique under general anaesthesia.
Arthroscope is a small fibre-optic viewing instrument made up of a tiny lens, light source and video camera. The camera attached to the arthroscope displays the image of the joint on a monitor, allowing the surgeon to view throughout the shoulder- cartilage, ligaments, and the labrum.
The approach for surgery is from the front (anterior) aspect of the shoulder. The surgeon makes small incisions around the joint. In one incision, the arthroscope is introduced to view the shoulder joint. Along with the arthroscope, sterile solution is injected to the joint which expands the shoulder joint, giving the surgeon a clear view to operate. Other portal is used for the insertion of surgical instruments to probe various parts within the joint to repair and reattach the damaged labrum. At the end of the procedure, incisions are closed with sutures.
The benefits of arthroscopy are smaller incisions, faster healing, a more rapid recovery, shorter rehabilitation period, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.
It is much less traumatic to the muscles, ligaments and tissues than the traditional method of surgically opening the shoulder with long incisions (open techniques).
After the surgery
Following the surgery, your surgeon may recommend you follow certain measures for a successful outcome:
- Your doctor will prescribe medications to relieve pain.
- Appling ice-packs wrapped in a towel on the shoulder for about 20 minutes, 3-4 times a day helps reduce post-operative swelling.
- Your surgeon will develop a rehabilitation program following surgery to improve the shoulder strength and range of motion.
- Return to normal activities once you feel comfortable and a follow-up appointment should be scheduled 8-10 days after surgery to examine your progress.
Risks and Complications
Complications of arthroscopic Bankart repair include infection, bleeding, damage to any nerve or blood vessel or delayed healing after the surgery. In certain cases stiffness of the shoulder joint may develop after the surgery.