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Arthroscopic Bankart Repair for Instability

About Bankart Repair Surgery

Arthroscopic Bankart Repair Surgery is an efficient procedure to treat patients that have anterior shoulder instability. The bulk of patients who suffer a traumatic anterior dislocation of their shoulder will tear the fibrocartilage labrum at the front of the shoulder. Many of those patients will go on to develop recurrent instability in their shoulder and keep dislocating. This may have a significant effect on the ability to participate in sport and sometimes also their work. It’s the tear in the labrum that is largely responsible for allowing their shoulder to continue to dislocate.

It is well established that if only patients with a pure labral tear are treated with an arthroscopic bankart repair then the results are as high as an open repair. The aim of surgery is to return people to full normal sporting and work activities and therefore the risk of a redislocation in this situation is less than 5% with a well-performed arthroscopic procedure.

The
Arthroscopic Bankart Repair Surgery repairs this tear within the labrum and by doing so restores stability to the shoulder. This procedure is often performed either open or arthroscopically. Previously it had been believed that the arthroscopic repair was not as successful as the open repair.

Patients that have torn not just the labral cartilage at the front of the shoulder but have also chipped off a segment of bone once they dislocated need a surgical procedure that will deal with bone loss. My preference during this situation is an arthroscopic Latarjet procedure.

What are the treatment options for a Bankart tear?

Most of the time, a doctor can use a procedure known as a closed reduction to move the dislocated shoulder back into position. Severe discomfort typically goes away once the shoulder bone is put back in place. The arm and shoulder are then confined in a sling or a splint for a number of weeks to recover. For pain, medication may also be recommended. Bankart repair surgery may be required to tighten stretched ligaments or reattach torn ones in the event of a shoulder that has been significantly dislocated or in situations where the surrounding ligaments or nerves have been injured.

Physical therapy is advised after the swelling and pain from the shoulder have reduced after the treatment to regain the shoulder’s range of motion, strengthen the muscles, and stop further shoulder dislocations. The shoulder may tend to be vulnerable to injury again which may further lead to chronic shoulder problems.

How is Bankart Repair Surgery Performed?

Bone anchors are drilled into the Glenoid to accomplish the arthroscopic Bankart repair. The anchors used right now are bio-composite anchors. Their crystalline structure will eventually give way to the bone. The torn cartilage (labrum) is then tied back to where it has been pulled off from the anterior Glenoid using sutures that are linked to the bone anchors. The shoulder is further tightened at the same time as the shoulder joint capsule, which had been stretched by the dislocation, is sutured to the anchors. This is called a capsulolabral plication.

Firstly, the aim of the Bankart Repair Surgery is to restore the normal anatomy of the shoulder by repairing and reattachment of the torn labrum. Under general anesthesia, bankart repair can be surgically done using an arthroscopic method. An arthroscope is a compact fiber-optic viewing device that consists of a small lens, a light source, and a camera. The surgeon can see the entire shoulder, including the cartilage, ligaments, and labrum, thanks to the camera attached to the arthroscope, which projects the image of the joint on a monitor.

Surgery is performed by entering the shoulder from the front (anterior) side. Around the joint, the surgeon makes a few tiny incisions. The arthroscope is inserted through one incision to view the shoulder joint. Sterile fluid is pumped into the joint along with the arthroscope, expanding the shoulder joint and providing the surgeon with a clear vision to do surgery. In order to repair and reattach the torn labrum, a different portal is employed for the introduction of surgical instruments to probe various regions inside the joint. Sutures are used to close incisions after the surgery.

Smaller incisions, quicker healing and recovery, a shorter recovery period, and reduced scarring are all advantages of arthroscopy. The majority of arthroscopic surgical operations are done as outpatient procedures, allowing the patient to go home the same day. Compared to the conventional procedure, which involves opening the shoulder with lengthy incisions, it is significantly less damaging to the muscles, ligaments, and tissues (open techniques).

Why DR.Apoorva Patwardhan for Bankart Repair Surgery?

Dr Apoorva Patwardhan’s clinic offers pioneering solutions for all kinds of shoulder-related problems. Guided by his diverse medical experience and arsenal of knowledge and skills, Dr. Apoorva is one of the best shoulder doctors in Pune who offers the latest treatments to all the patients to restore their ability to perform daily tasks and return to professional activities, like sports, too.

What is the success rate of Bankart Repair?

The estimated success rate of Bankart Repair Surgery depends on the factors like Patient’s age, the patient’s medical condition, the experience of the surgeon and the type of surgery or procedure performed. In most cases, the success rate of Bankart Repair is about 90%.

What are the risks associated with shoulder bankart surgery?

Just as with any given surgery, Bankart Repair surgery is associated with a couple of risks depending on the various stages. During the perioperative, nerve injury can happen during surgery and poor keeping anchor sutures. In about six weeks post-surgery, wound infection or rupture of the repair can happen. From 6 weeks and 6 months, the shoulder may have some stiffness or recurrence of instability. A possibility of failure of the repair can result in shoulder weakness. Sutures opening is also a possibility.

FAQ’s

Bankart lesions are often the result of extreme trauma or sports injuries either because of high impact or repetitive stress. Although the injury can happen to anyone, usually people in their 20s are more vulnerable to this type of injury.

The average cost of a Bankart Repair Surgery is around Rs 89,000 in Pune. The cost can go up depending on the appointment fees, age and condition of the patient, expertise of the surgeon, the type of hospital, what admission room is chosen and other surgery related expenses like medicines, ECGs, X-rays etc.

The estimated success rate of Bankart Repair surgery depends on various factors like Patient’s age,medical condition,surgeon’s experience and the type of surgery or procedure performed. In most cases, the success rate of Bankart Repair is about 90%.

The average time taken for completing a Bankart repair surgery is around 2-3 hours.

Bankart Surgery is opted when the following indications are seen, a traumatic or atraumatic shoulder, a shoulder joint dislocation, joint instability, rotator cuff repair or an impingement of the shoulder joint.