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Bankart Repair
Bankart repair is a procedure used to treat shoulder instability caused by a tear in the labrum – the cartilage that supports the shoulder joint. This tear, known as a Bankart lesion, commonly occurs after repeated shoulder dislocations. The surgery aims to stabilise the shoulder by repairing the torn labrum and tightening the surrounding tissues to prevent future dislocations.
Dr Dennis Ng Zhaowen
Indications |
Benefits |
Types |
Preparation |
Procedure |
Recovery |
Risks |
FAQ
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Indications for Bankart Repair
Bankart repair is recommended for individuals with shoulder instability caused by a Bankart lesion. Common indications include:
- Recurrent Shoulder Dislocations - Surgery is considered when frequent shoulder dislocations affect daily activities or participation in sports.
- Failed Non-Surgical Treatments - If treatments such as physical therapy, medication, or bracing have failed to improve shoulder stability, surgery may be needed to address the underlying structural damage to the labrum.
- Shoulder Weakness or Instability - Patients with ongoing shoulder weakness or instability during normal movements, such as lifting or reaching, may benefit from Bankart repair.
- Damage to the Labrum - Imaging tests that show a tear in the labrum (Bankart lesion) are a strong indication for surgery, particularly if the damage has not healed with non-surgical methods.
Benefits of Bankart Repair
Bankart repair offers several benefits, especially when non-surgical methods are insufficient.
- Improved Shoulder Stability: The surgery restores normal shoulder function by reattaching the torn labrum and tightening tissues, reducing excessive joint movement.
- Reduced Risk of Future Dislocations: Bankart repair stabilises the shoulder, reducing the chance of future dislocations. This allows patients to resume activities confidently without fear of sudden disruptions.
- Enhanced Range of Motion and Functionality: With proper healing, patients regain mobility, making it easier to perform daily tasks and sports activities without restrictions.
- Pain Relief: By stabilising the joint, the surgery addresses the root cause of pain, leading to greater comfort and reduced inflammation.
- Prevention of Long-Term Joint Damage: By preventing repeated dislocations, Bankart repair protects the joint from wear and tear, lowering the risk of arthritis and future surgeries.
Types of Bankart Repair Procedures
Bankart repair can be performed using different surgical techniques, depending on the severity of the condition and the patient’s needs. These include:
Arthroscopic Bankart Repair
This minimally invasive procedure involves making small incisions around the shoulder and inserting an arthroscope (a small camera) to guide the repair. Surgical instruments are used through these incisions to reattach the torn labrum to the shoulder socket.
Open Bankart Repair
In this procedure, a larger incision is made to directly access the shoulder joint. It is typically recommended for more complex or severe labral tears that cannot be adequately treated with arthroscopic techniques.
Remplissage Procedure (if applicable)
In some cases, a remplissage procedure may be performed along with Bankart repair. This technique fills a defect in the humeral head (Hill-Sachs lesion) using part of the rotator cuff, helping to prevent future dislocations.
Preparing for Surgery
Preparation for Bankart repair surgery involves several steps to ensure a smooth procedure and reduce the risk of complications.
- Medical Evaluation
Patients will undergo a thorough medical assessment to ensure they are fit for surgery. This includes a review of medical history, physical examination, and blood tests to confirm suitability for the procedure. - Imaging Tests
Imaging tests help assess the severity of the labral tear and guide surgical planning. An MRI provides detailed images of soft tissues, such as the labrum and tendons. A CT scan focuses on bone structures, useful for identifying issues like Hill-Sachs lesions (a bony defect on the humeral head) or fractures. - Medication Adjustments
Patients may need to stop taking certain medications, such as blood thinners or anti-inflammatory drugs, before surgery to reduce the risk of excessive bleeding during the procedure. - Fasting
Patients are required to fast for several hours, typically starting at midnight before the procedure to reduce the risk of complications related to anaesthesia.
Step-by-Step Procedure
The following steps outline the surgical process for Bankart repair:
Anaesthesia
General anaesthesia is administered to ensure that the patient is asleep and painless during surgery. In some cases, regional anaesthesia may be used to numb the shoulder area. The choice between general and regional anaesthesia depends on the patient’s condition and surgeon’s recommendation.
Incisions and Access
The type of Bankart repair determines the size and placement of incisions. For arthroscopic repair, several small incisions are made around the shoulder to insert an arthroscope and surgical instruments for precise repairs. Open Bankart repair requires a larger incision for direct joint access, usually reserved for more severe tears.
Labrum Repair and Tissue Tightening
The surgeon reattaches the torn labrum to the shoulder socket using anchors or sutures, restoring stability to the joint. If needed, the surrounding tissues are tightened to reduce excessive joint movement. In cases where a Hill-Sachs lesion is present, the remplissage procedure may also be performed.
Closing the Incisions
After the repair is completed, the incisions are closed with sutures or surgical tape. The area is then bandaged to keep the shoulder protected.
Post-Surgical Monitoring and Recovery
Recovering from a Bankart repair requires a structured process to ensure proper healing and restore shoulder function.
Immediate Post-Surgical Care
Following surgery, the patient is monitored in a recovery area while the anaesthesia wears off. Pain relief medications are provided to manage discomfort, and the shoulder is placed in a sling to protect the joint and limit movement during the initial healing phase.
Physical Therapy
Physical therapy begins shortly after surgery to restore mobility, strength, and stability. Initially, gentle exercises prevent stiffness and maintain flexibility. As healing progresses, strengthening the rotator cuff and surrounding muscles supports the repaired labrum, with stability exercises improving joint control. A gradual increase in activity helps restore function while minimising the risk of reinjury.
Recovery Timeline
Full recovery from Bankart repair typically takes 4 to 6 months, though individuals involved in contact sports or physically demanding activities may need 6 to 9 months before returning to full performance. Follow-up visits help monitor progress and allow for adjustments to therapy as needed. Patients are advised to gradually increase shoulder use to avoid overloading the joint too soon, helping prevent long-term complications.
Potential Risks and Complications
Though uncommon, risks of Bankart repair include infection at incision sites, potentially needing antibiotics, and bleeding, which may require medical care. A nerve or blood vessel injury can cause numbness or weakness in the arm. Some patients may also develop stiffness or limited motion, often managed with physical therapy.
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #08-41
Singapore 329563
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Saturday: 9am – 1pm
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6 Napier Road #07-15
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Frequently Asked Questions (FAQs)
How long will I need to wear a sling after surgery?
The sling is usually worn for 4 to 6 weeks to protect the shoulder and prevent strain on the healing tissues. Your doctor may adjust this timeline based on your progress, with the sling worn full-time initially and gradually reduced as you begin physical therapy.
How can I sleep comfortably after surgery?
Sleeping in a reclined position or using pillows to prop up the arm can help reduce discomfort and prevent excessive shoulder movement. Many patients find sleeping in a recliner or on their back with the sling in place to be the most comfortable option during the first few weeks.
What are the chances of shoulder dislocation after Bankart repair?
While Bankart repair significantly lowers the risk of future dislocations, there is still a small chance of recurrence, especially in athletes or those with physically demanding activities. Adhering to rehabilitation and gradually resuming activity helps minimise this risk.