An Overview on Bankart Repair (Capsulolabral Reconstruction)
The shoulder joint is responsible for providing stability when performing overhead motions, such as throwing and catching. The shoulder consists of numerous ligaments and tendons that aid in stability and mobility. Dislocations and ligament tears, such as labral and capsule tears, are quite common in the athletic population due to a fall on an outstretched hand or having the arm jerked during a game. When a shoulder dislocation occurs in the most frequent direction, towards the front (or anterior) part of the shoulder, the anterior-inferior ligament can be torn along with the labrum. This particular shoulder injury is called a Bankart Lesion. A Bankart repair, or capsulolabral reconstruction, is commonly performed to tighten and repair the damaged labrum and ligaments. Shoulder surgeon Dr. Brian Waterman performs Bankart repairs and provides Bankart repair protocols for patients ranging from professional athletes to the general population. Less commonly the shoulder can dislocate in a posterior direction results in a posterior labrum tear. Lastly, some shoulder are unstable in multiple directions with significant injury to the capsule and labrum on both sides of the shoulder.
A capsulolabral reconstruction, Bankart repair, is a relatively new procedure highly effective at treating acute or chronic shoulder instability. A Bankart repair can be performed as an arthroscopic surgery or open surgery using a transplanted tendon to compose new cartilage and ligaments. With an arthroscopic approach, the damaged labrum is repaired and the stretched anterior shoulder capsule is manipulated to lie on top and make the capsule smaller. The goal of a Bankart repair is to stabilize the shoulder joint and prevent future dislocations.
During the outpatient procedure, the shoulder is examined under anesthesia to determine the degree and direction of instability. Next small incisions are made in the shoulder and a camera is introduced. Using specialized insruments and suture anchors, the torn or stretched labrum and capsule are repaired back to their normal position.
Bankart Repair Protocols
Dr. Waterman requires all patients to wear a sling for approximately six weeks so the repaired labrum can continue to heal to the glenoid bone. In order to achieve maximum results from the Bankart repair, it is crucial to follow a set of Bankart repair protocols.
The following general Bankart repair protocols are recommended:
- Apply ice to the incision site to help alleviate the pain following surgery.
- Use pain medication as directed by Dr. Waterman and his team.
- Use a sling only as recommended, and do not discontinue use until directed.
- Use of the arm is restricted. Patients are expected to keep the arm immobile. .
- Good posture is important during the rehabilitation process to aid in good shoulder mechanics and improve healing.
- Rehabilitation will begin approximately four to eight weeks after the Bankart repair. Dr. Waterman will prescribe a program that focuses on range of motion and shoulder strength.
- In many cases, patients can return to overhead sports in approximately three months and contact sports after six months.
Please note that all Bankart repair protocols are for general information only. Dr. Waterman and his orthopedic team will provide complete recovery and rehabilitation guidelines to all patients based on the patient’s unique injury, treatment and rehabilitation process.