Bankart repair for unstable dislocating shoulders: Surgery to anatomically and securely repair the torn anterior glenoid labrum and capsule without arthroscopy can lessen pain and improve function for active individuals.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Tuesday, November 13, 2007
Figure 8 - Location of cosmetic incision Figure 10 - Repaired capsule and labrum About the procedureTechnical details Shoulder instability surgery is a highly technical procedure; each
step plays a critical role in the outcome. After the anesthetic has
been administered and the shoulder has been prepared, a cosmetic
incision is made in a natural skin crease at the front of the shoulder
as shown in figure 8.
This incision allows access to the seam between the deltoid and the
pectoralis major muscles. Splitting this seam allows access to the
shoulder without detaching or damaging the important deltoid muscle,
which is responsible for a significant portion of the shoulder's power.
All scar tissue is removed from the space beneath the deltoid.
The tendon of the subscapularis muscle is incised (see movie 6),
providing excellent access to the interior of the shoulder joint and a
view of the detachment of the labrum and ligaments from the glenoid
socket (see movie 7), as shown in figure 9.
The goal of the repair is to reattach securely the labrum and
ligaments to the area from which they were torn. This is accomplished
by roughening the edge of the glenoid socket (see movie 8) and drilling
small holes through its lip in the area of the tear (see movie 9).
Passing suture (surgical thread) through these holes (see movie 10) and
then through the detached labrum and ligaments (see movie 11) restores
the anatomy of the shoulder and the depth of the glenoid socket when
the suture are tied, as shown in figure 10.
At the conclusion of the repair the subscapularis tendon is repaired anatomically, as shown in figure 11 and movie 12.
A cosmetic closure of the skin incision is carried out, dressings are applied, and the arm is placed in a sling.
QuickTime movies
Anesthetic Shoulder instability surgery may be performed under a general
anesthetic or a brachial plexus nerve block. A brachial plexus block
can provide anesthesia for several hours after the surgery. The patient
may wish to discuss their preferences with the anesthesiologist before
surgery.Length of surgical repair for shoulder dislocations The procedure usually takes approximately one hour, but the
preoperative preparation and the postoperative recovery may add several
hours to this time. Patients often spend two hours in the recovery room
and about two days in the hospital after surgery.Surgery for shoulder dislocations at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-7416 to make an appointment.
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