Thursday, September 17, 2015

Bankhart Repair – Arthroscopic Stabilization of the Shoulder

Bankhart repair, also known as arthroscopic labrum repair of the shoulder, is performed to fix a detached labrum.
Bankhart repair, also known as arthroscopic labrum repair of the shoulder, is performed to fix a detached labrum. The labrum is a circumferential structure that is surrounds the glenoid, which is the boney socket of the shoulder. There are also ligaments that surround the shoulder that attach to the labrum. Together the labrum and the attached ligaments act as a stabilizer for the joint.

A Bankhart tear occurs when the labrum is torn away from the bone. These tears are often a result of a shoulder dislocation which also tears the anterior inferior glenohumeral ligament. Because the ligaments and labrum are no longer attached to the bone, the shoulder becomes unstable and requires appropriate treatment.

Acute Bankart tears are more common in young individuals, usually under the age of 35. Initially, conservative treatment may be implemented, but if repeat shoulder dislocations occur, surgical repair of the labrum and ligaments is recommended. When surgery is indicated, arthroscopic stabilization of the shoulder or a Bankart repair is performed. 

How is the Bankart Repair Performed?

The Bankhart repair is performed by making a few small incisions in the front and back of the shoulder. A video camera (arthroscope) is inserted to view the inside of the shoulder joint. Small instruments are then inserted to perform the repair. 

The first step of the Bankhart repair is to prepare the area around the detached labrum. Any loose particles are removed and rough edges are made smooth. The orthopedic surgeon then drills a small hole in the bone by the detached labrum. An anchor and suture are then placed in the hole, and the suture from the anchor are sewn into the labrum and pulled tightly to reattach it to the glenoid. The steps are repeated for each anchor, and the amount of anchors used depends on the size of the labrum and ligament tear. The small incisions are then sutured closed. 

After the procedure, the patient is asked to remain in a sling for about 4 weeks to allow the labrum to heal to the bone. Physical therapy is then typically prescribed 3x a week for 12 to 16 weeks. Patients can normally return to desk work after 2-4 weeks and physical labor and sports within 4 months. 

If you suspect you have a labral tear it is important to see an orthopedic surgeon. To schedule an appointment with board certified orthopedic surgeon, John Vitolo, MD, call 973-300-1553.