Bankart Shoulder Repair
(Repair Unstable Dislocating Shoulders)
A Bankart Shoulder Repair procedure is a surgical technique for the repair of recurrent shoulder joint dislocations. Within the procedure, the worn out ligaments are re-attached to the proper place in the shoulder joint, using the objective of rebuilding normal function.
The shoulder is easily the most commonly dislocated major joint following severe trauma, such as an auto collision or perhaps a fall onto an outstretched arm. Some 96% of dislocations involve the front of the shoulder (anterior), with 1-3% occurring in the back (posterior). Falls and car accidents are common causes of first-time dislocations, but recurrent dislocations in many cases are because of seemingly inoffensive activities such as raising the arm over the head, or combing hair. Shoulder dislocations are more common in males than females, as well as in teenagers
Bankart Shoulder Preparation
The orthopedic doctor needs to be informed of health issues, including allergies and the non-prescription and prescription drugs.
- Initial Surgical Consultation.
Preoperative X-rays, a complete medical history, a complete surgical history, and a complete list of all medications (prescription, over-the-counter, vitamin supplements) and allergies will be reviewed. - Complete Physical Examination.
Your surgeon will perform a physical examination and determine if your internist or family physician should assist with optimization of medical conditions prior to the surgery. This will ensure that you are in the best physical condition possible on surgery day. - Physical Therapy.
Instruction in an exercise program to begin prior to surgery, as well as an overview of the rehabilitation process after surgery, will better prepare you for postoperative care. - Preparation for Surgery.
You may want to wear loose-fitting clothes. You should bring your insurance information and a list of all your medications and dosages as well as drug allergies. You will need to arrange for someone to drive you home. - Evening Before Surgery.
Do not eat or drink after midnight. Your surgeon or anesthesia provider may recommend that you take some of your routine prescription medications with a sip of water
Bankart Shoulder Repair Procedure
The Bankart Shoulder Repair procedure involves small incisions around the shoulder region. The orthopaedic specialist can then insert a tiny camera so he/she can view the structures on a TV monitor. The labrum is attached to the glenoid bone using small instruments. To hold the tissue in place, the surgeon inserts small anchors into the bone on and stitches to suture the labrum in place.
With the open shoulder stabilization procedure, the Bankart lesion is repaired and stability of the shoulder is restored. This operation involves a large incision over the front of the shoulder joint so the doctor can reposition the labrum and ligaments. This operation is best for individuals who have a completely detached labrum from a violent dislocation.
Both surgeries are performed under general anesthesia and can take anywhere from 1 ½ hours to 2 ½ hours. The arm nerves are numbed with a local anesthetic so the pain relief lasts up to 24 hours (called a regional block). Also, a bulky dressing is applied to the surgical sites following either of the two procedures
Recovery after the Bankart Shoulder Repair
The Bankart Shoulder Repair procedure can require you to stay overnight in the hospital. The stitches will not be removed for 10 to14 days. Expect your arm to be positioned in a bulky immobilizer sling. Many surgeons will administer pain medications and antibiotics following the surgery, to alleviate pain and prevent infection. The week after surgery, a physical therapist will meet with you to instruct you on exercises and home care. Expect to only be able to use your non-surgical hand for the first four weeks after the Bankart Shoulder Repair procedure. You will be allowed to drive a car at around six weeks, and should be using the shoulder by week 10. Contact sports are not usually allowed until six months following the surgery, but activities such as swimming are allowed at around three months.
Risks
The following risks are found in Bankart Shoulder Repair procedure:
• Perioperative: Nerve injury during surgery and poor keeping anchor sutures.
• Within six weeks after surgery: Wound infection and rupture of the repair.
• Between 6 weeks and 6 months: Shoulder stiffness, recurrence of instability, failure of the repair resulting in shoulder weakness, failure of the anchor sutures.