The shoulder joint is a ball and socket joint, where the head of the upper arm bone attaches to the shoulder socket. The shoulder socket is extremely shallow and therefore needs additional support to keep the shoulder bones from dislocating. The labrum, a cuff of cartilage that encircles the shoulder socket, helps serve this purpose by forming a cup for the humeral head to mo've within. It provides stability to the joint, enabling a wide range of movements.
The labrum can sometimes tear during a shoulder injury and a specific type of labral tear that occurs when the shoulder dislocates is called a Bankart tear. This is a tear to a part of the labrum and is common in younger patients who sustain a dislocation of the shoulder. A Bankart tear makes the shoulder prone to repeated dislocations in patients under 30 years of age.
Conservative treatment measures for a Bankart tear include rest and immobilization with a sling followed by physical therapy. When conservative treatment measures do not improve the condition and repeated shoulder joint dislocations occur Bankart repair surgery is indicated
Bankart surgery can be performed by a minimally invasive surgical technique called arthroscopy. During an arthroscopic Bankart procedure, the surgeon makes a few small incisions over the shoulder joint. An arthroscope, a small tubular device attached with a light and a small video camera at the end is inserted through one of the incisions into the shoulder joint. The video camera transmits the image of the inside of your shoulder joint. Images are projected onto a television monitor for the surgeon to view. Very small surgical instruments are inserted through tiny incisions to trim the edges of your glenoid cavity. Suture anchors are then inserted to reattach the detached labrum to the glenoid. The tiny incisions are then closed and covered with a bandage.
Arthroscopy causes minimal disruption to the other shoulder structures and does not require your surgeon to detach and reattach the overlying shoulder muscle (subscapularis) as with the open technique.
After surgery, the patient usually will spend an hour in the recovery room.
Physical therapy and shoulder exercises will be recommended and start the day following surgery to strengthen and improve the range of motion of the shoulder joint. Usual daily activities may be performed as tolerated excluding lifting objects heavier than a plate. The arm may be placed in a sling to restrict use of the operated shoulder. Some lower risk activities, like jogging and swimming may be started again 8 to 10 weeks after surgery.