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. 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.

Case Study: Repeated Shoulder Dislocations and the Latarjet Procedure

Recently, we had an interesting case with a young man in his early 20’s. The patient had dislocated his shoulder “100 times” following a previous surgery (anterior labral repair) performed by another physician. Shoulder dislocation is not only painful, but debilitating. The patient stated that any movement would cause the shoulder to dislocate – even in his sleep. 

A CT Scan was performed to look at the structure of the shoulder bones and revealed that the glenoid bone (the socket of the shoulder) was missing (see pictures). The repeated dislocations likely caused the loss of the front of the glenoid bone. If not repaired, the shoulder would continue to dislocate. 

Normal Glenoid

CT Scan of Missing Bone on Glenoid

In this case, we opted to perform an open surgery known as the Latarjet Procedure. The Latarjet procedure was first performed in France by a French surgeon, Michel Latarjet. The procedure has excellent success rates in patients with recurrent dislocations and recurrence of injury is low. 

In the Latarjet procedure, a portion of bone is taken from scapula (shoulder blade) called the corocoid. The corocoid is a hook of bone located in the front of the shoulder blade. In the Latarjet procedure the corocoid is removed from the scapula, with the muscles still attached. The corocoid is then screwed into the shoulder socket where it replaces the lost bone (see picture below). The attached muscles are then secured to offer support in the front of the shoulder. 

In this case, the surgery was a great success. The patient was in a sling for 4 weeks following surgery to protect the repair. He then performed physical therapy 3x/week for 16 weeks and is no longer dislocating his shoulder. The patient is very happy with the results. 

Latarjet Repair - Bone restored to prevent dislocation

John Vitolo, MD is a board certified orthopedic surgeon specializing in injuries and conditions of the shoulder and knee. With over 25 years of experience, Dr. Vitolo is an expert in the field. To make an appointment, please call 973-300-1553 or visit advocareorthosportsmed.com to learn more.