A Bankart repair, also sometimes called shoulder arthroscopy or a labral repair, is a surgical procedure to fix a Bankart lesion, which is an injury that can occur after a person dislocates his shoulder. This particular injury is a tearing of a ligament called the inferior glenohumeral, which is responsible for keeping the shoulder joint in position. A Bankart repair involves removing severely damaged tissue, repairing the ligament, and possibly repairing the cartilage, if needed. The usual recovery time for this type of surgery may be as long as six months, so patients may wish to consider other treatment options first, such as physical therapy.
Prior to the surgery, patients must discuss their medications and supplements with the surgeon, as well as their other medical conditions. They may need to discontinue certain drugs, such as blood thinners, for a period of time beforehand. Bankart repair surgery may be performed either under general or regional anesthesia, however general anesthesia is most commonly used. Those who are nervous about the procedure should request general anesthesia, so that they are entirely unconscious. Regional anesthesia will completely numb the area, and the anesthesiologist will also administer a strong sedative.
If a Bankart repair is to be performed with open surgery, the surgeon will make a large incision in the shoulder area. Arthroscopic surgery requires one to three smaller incisions through which an arthroscope is inserted. This instrument contains a tiny camera to allow the surgeon to evaluate the damage. Sometimes, with very severe damage, the surgeon will need to perform open surgery even after beginning with arthroscopic surgery. He will remove damaged tissues and repair the torn ligament, closing the incisions with stitches afterward.
Most patients do not have to remain in the hospital overnight following a Bankart repair. They should have someone else drive them home. The surgeon will provide specific instructions for post-operation recovery; however, in general, the patient can expect to use ice packs at intervals throughout the first two days. He must wear a sling on the affected arm for about one week and will need to change the dressings as recommended by the doctor.
Patients should also place a pillow or two under the affected arm when sleeping. Some people may find it more comfortable to sleep in a reclining chair. They will work with a physical therapist the same day of the surgery to learn range-of-motion exercises for the wrist and hand. As the shoulder begins to heal, the physical therapist will gradually add arm exercises to the patient's routine. The full recovery from a Bankart repair can take between one to six months, depending on the extent of the damage.
Before undergoing a Bankart repair, a patient should be aware of the potential risks. He may experience an adverse reaction to the anesthesia, or develop an infection or a blood clot. The risk of a blood clot is elevated for those who are overweight, taking birth control pills, or those who have a personal history of cancer. Some patients may also experience shoulder stiffness, weakness, or failure of the surgery, which necessitates further repairs.