WHAT IS BANKART LESION?
Most important ligament stabilising surgery to prevent recurrent dislocation of the
Bankart lesion is the tearing of the ligament from the front of the socket of the
shoulder. This is present in 97-99% of shoulder dislocations and is the cause of recurrence as it does not
heal without surgery and if it does, it does so in non-anatomical position because of which shoulder looses
Is there a chance of bankart lesion stabilising without surgery?
This largely depends upon age! If the first dislocation happens in teen age ( <19 years
of age) then the chances of healing of this ligament are practically nil (Recurrence of dislocation is
more than 99%). However, as the age advances e.g. in a 40 years old individual, there are 30-40 %
chances for the shoulder to stabilise without surgery after one episode of dislocation.
Why does the shoulder dislocate again & again?
Because ligament tear does not heal and with each episode of dislocation, bone gets damaged
on the socket (Glenoid bone loss) and the ball (Humeral head bone loss) setting up a vicious circle!
How do we treat recurrent dislocation of
Arthroscopic Bankart Repair: With key-hole incisions, telescopic camera is inserted
into the joint and instruments are inserted
from separate tiny incisions and torn ligament (Bankart lesion) is re-attached to the socket.
When bone loss on the front of the socket exceeds critical limit, ligament repair cannot hold the fast
ball on the socket. We need to support the ball with bone augmentation on the socket. This is cleverly
done by taking coracoid
process in front of the socket and xing it with the socket. It is done by an incision which hides
partially in the axillary crease! This is
also a very successful procedure when indicated.
Arthroscopic Remplissage and Bankart repair:
Sometimes, the defect in the ball of the shoulder is large so that it becomes
wider than the socket!! In such scenarios, we need to do Bankart repair and in addition we fill the
defect (French word Remplissage)
with Muscle at the back of the shoulder. This is done all by key-hole surgery.
- What is the success rate of these surgeries?
- The best outcome is achieved when surgery is done early. Once the damage increases, additional
procedures like Latajet /
Remplissage are needed and then there are increased chances of failure.
- Generally speaking, success rates are as high as 97%-99% in properly indicated patients.
What are the risk factors for recurrent dislocation of
- a) Ligamentous laxity (Genetic)
- b) Over-head sports
- c) Contact sports
Tips to prevent shoulder dislocation
- a) Keeping the rotator cuff muscles strong
- b) Keeping the scapular blade muscles strong
- c) Proper techniques of weight training e.g. avoiding fall of elbows behind the body during deceleration phase in inclined