Bankart Repair

BANKART REPAIR OPEN

 

 

Purpose

To repair the detached antero-inferior labrum ( Bankart Lesion) to the glenoid with minimal restriction of external rotation.
Indications

Patients with a Bankart Lesion and recurrent dislocation of the shoulder joint ( glenohumeral joint)
Skin Incisions
Delto pectoral
Approach

Superficial muscles are separated and deep muscles divided. The capsule of the joint is opened. All these structures are repaired at the end of the proceedue.

 

 

Procedure

The edge of the glenoid is roughened to produce an improved surface for the repair.A number of either Titanium or Bioabsorbable anchors, usually 3, are inserted into the margin of the glenoid. These embedded ‘anchors’ grip the bone and allow the labrum to be tightened against the glenoid via sutures passed through both the labrum and the anchor. In this way the Bankart lesion is repaired, allowing the tissues to heal in this position.

      Possible Associated Procedures
  • Examination under anaesthesia
  • Arthroscopic assessment of the lesion
  • Inferior capsular shift ( link)
  • SLAP repair
    Rotator Interval Repair
    Main Possible Complications
  • Infection
  • Nerve damage
  • Blood vessel damage
  • Recurrence of anterior instability
    Shoulder stiffness

 

      After the operation
  • The arm will be rested in a controlled position in a sling or brace. The Physiotherapist and nursing staff will show you how to adjust and safely remove and apply this. (Link to living with a sling –ULTRASLING II ER and picture)
  • You will not require an x ray
  • You will usually be able to return home the same day or following day
  • You can expect to use painkillers for two after surgery, three times a day and from then, over the following 4 weeks, an hour before a physiotherapy or more intense exercise session.
  • You will be shown specific shoulder and arm exercises by your physiotherapist before you leave the hospital. These exercises are very important and must be carried out accurately after leaving the hospital on a daily basis at home; ideally 3 times a day. It is very important that you DO NOT EXTERNALLY ROTATE the shoulder during the first four weeks after surgery. Make sure that you are shown this by the physiotherapist before leaving the hospital.
  • The stitches must be removed or the wound inspected (if absorbable sutures are used) at 14 days after surgery; either with your GP’s practice nurse or at the hospital.
BANKART REPAIR ARTHROSCOPIC

 
Purpose

To repair the detatched antero-inferior labrum( Bankart Lesion ) to the glenoid with minimum loss of external rotation.

Indications

The procedure is appropriate for patients with a torn labrum, diagnosed by arthroscopic evaluation or MRI scan. Repair is indicated especially after recurrent dislocation but should be considered after the first dislocation in higher demand sports men and women.

 

Skin Incisions

Three incision portals are used: anterior ,anterior-superior and posterior.

DIAG HERE

Procedure

During the operation a full diagnostic evaluation of the glenohumeral joint is made. The labrum, the degree of damage to the head of the humerus ( Hill Sachs Lesion), the degree of laxity in the glenohumeral capsule and ligaments are all assessed. Concurrent pathology is excluded.
The procedure holds the labrum in the repaired position, allowing the tissues to heal.

      Possible Associated Procedures
  • Arthroscopic assessment of the gleno humeral joint
  • Arthroscopic capsular shift
  • SLAP repair
    Main Possible Complications
  • Infection
  • Nerve and blood vessel damage
  • Recurrence of anterior instability
  • Shoulder stiffness
    After your operation
  • The arm will be rested in a supported position in a sling or brace. The physiotherapist or nursing staff will show you how to adjust and safely remove and reapply this (link to living with a sling ULTRASLING II ER)
  • You will not need an x ray
  • You will either go home the same day or the day after
  • You can expect to need painkillers for one or two weeks after surgery to control the background pain and from then an hour before a physiotherapy or heavier exercise session.
  • You will be shown specific shoulder and arm exercises by your physiotherapist before you leave the hospital. These exercises are very important and must be carried out accurately after leaving the hospital on a daily basis at home;ideally 3 times a day.It is very important that you DO NOT EXTERNALLY ROTATE THE SHOULDER during the first four weeks after surgery. Make sure that you are shown this by your physiotherapist before leaving the hospital.
  • The stitches must be removed, or the wound inspected( if absorbable sutures are used) at 14 days after surgery; either with your GPs practice nurse or at the hospital.