Bankarts Repair or Labral Repair

Diagnosis

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Shoulder instability. Repeated movement of the shoulder bone out of the socket (recurrent dislocations) is the cause of concern in patients usually belonging to the age group of 18 to 40. Apprehension sign where the patient experiences the scare of joint dislocation in certain angles of shoulder movement is noted.

X-ray. Xray may reveal if there is a bony Bankarts, where a fragment of bone is lifted up from the front edge of the socket (Glenoid bone). Xray may also reveal a large dent in the back part of the upper portion of the shoulder bone (head of the humerus). However, in majority of patients with this problem, X-ray may not reveal any abnormalities.

MRI Scan. With contrast is the gold standard investigation for identifying the extent of the tear of the lip (labrum), the dent (Hill Sach’s lesion) on the back side of the shoulder bone due to rubbing against the front of the socket.

 

Treatment

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Acute dislocation of the shoulder joint needs immediate medical attention to reduce the shoulder joint back into place. Once the pain and inflammation reduces, it needs a prompt assessment regarding the risk of further dislocation.

 

Bankarts repair or Labral repair

 

In patients with risk of repeated dislocations, a key-hole surgery (arthroscopy) is undertaken to repair the lip (labrum) back to the edge of the socket bone where it is supposed to be attached. This procedure is done usually by using bio-composite suture anchors. If there is a large dent (Hill Sach’s lesion) on the back of the bone, then a procedure to attach the back capsule to the bone (Remplissage) is done.

If a large bone fragment is lifted off from the front edge of the socket, it may need a procedure where a bone block (Latarjet) procedure may be required.

 

Rehabilitation

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Post-surgery, for the first 3 weeks using a broad arm sling is recommended. Gentle passive stretches are started early. After 3 weeks, active movements are started. Return to non-contact sports by around 4 months and for contact sports by 6 months.

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