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.
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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.
