Bankart repair is an operation to fix the most common injury behind a dislocated shoulder: a tear of the labrum, the rim of soft tissue that deepens the socket, at its front and lower edge. The repair is done by arthroscopy (keyhole surgery) and aims to restore stability in a shoulder that keeps slipping out. Many people who dislocate a shoulder once do not need it.
What happens when the shoulder dislocates
The shoulder is a ball and a shallow socket, which is why it moves so freely and also why it is the joint that dislocates most often. In most dislocations the ball slips forwards and downwards, usually after a fall on the arm, a sports collision or a twisting injury with the arm raised.
As the ball comes out, the labrum and the ligaments attached to it can peel off the bone of the socket. This detachment is called a Bankart lesion. The ball can also get a dent on its back surface, called a Hill-Sachs lesion, and in some injuries a piece of the socket rim is chipped as well.
Signs of an unstable shoulder
- One or more episodes of the shoulder coming out, or feeling as if it is about to.
- Apprehension when the arm is placed out to the side and turned outwards, as in throwing or reaching back.
- Slipping, clicking or a dead-arm feeling during sport or overhead tasks.
- Pain and weakness after an episode that does not settle.
If a shoulder dislocates for the first time
Do not try to put it back yourself. Support the arm in a sling and go to a hospital emergency department, where the joint is put back in place and an X-ray is taken. A sling is used for a short period, and an orthopaedic review is advised afterwards, because the labrum, the rotator cuff and the bone may need to be assessed.
How the injury is assessed
Examination checks stability, movement, strength and the nerves around the shoulder. X-rays show the position of the joint and any bone injury. An MRI, often with dye injected into the joint (MR arthrogram), shows the labrum and the cuff. A CT scan is sometimes added when significant bone loss from the socket or the ball is suspected, because that changes the choice of operation.
Who is considered for Bankart repair
- People whose shoulder has dislocated more than once, or keeps slipping during daily activity.
- Younger, active people and those in contact or overhead sport, in whom a second dislocation is more likely. After a first dislocation, surgery may be discussed in selected patients.
- Those with an MRI showing a labral tear that fits the symptoms, and no large bone loss.
Many first dislocations, especially in people who are less active, are managed with a sling and physiotherapy. In people over about 40, a first dislocation is more often accompanied by a rotator cuff tear, so the cuff is looked at carefully. If there is significant bone loss, or an earlier repair has failed, a different operation may be needed instead: the Latarjet operation, a bone-block procedure that moves a piece of bone to the front of the socket rim. Dr. Aman performs this operation, and it is discussed at consultation.
How arthroscopic Bankart repair is done
The operation is done under anaesthesia through a few small cuts around the shoulder. A camera shows the inside of the joint on a screen. The surgeon lifts the torn labrum and capsule off the bone, roughens the socket edge slightly and then reattaches the tissue using tiny screws that carry stitches (suture anchors) placed in the socket rim, tightening the capsule at the same time. The cuff and the rest of the joint are checked during the same procedure.
Recovery in general terms
In Dr. Aman's practice the shoulder is usually supported in a sling for 3 to 4 weeks, followed by guided physiotherapy that moves from gentle motion to strengthening. Desk work and driving usually return earlier than overhead or contact activity, and a return to contact sport is usually allowed at about six months. Your surgeon and physiotherapist move you on as the repair heals.
Risks in general terms
The main risks of shoulder stabilisation are stiffness, the shoulder slipping again, infection and persisting pain. Injury to nerves or blood vessels is uncommon, and anaesthesia can cause reactions. Your surgeon explains how these apply to you before you decide.
When to see a doctor
See a doctor if your shoulder has come out of joint more than once, feels loose during activity, or has not recovered after a first dislocation. Seek emergency care for a shoulder that is currently out of joint, or for numbness or loss of colour in the arm or hand.
Booking an OPD visit
When you message on WhatsApp, say what happened and send any scan reports. The clinic and hours page has OPD timings in Surat.