Our shoulder is the most mobile joint in the body.The movement is dependant on muscles, ligaments including the capsule and rim of cartilage to stabilize it during the movement. Many injuries to the shoulder can dislocate it,stretching,tearing the joint capsule and ligaments away from the front of the joint. A tear of the anterior-inferior labrum is called a “Bankart Lesion”. The Operation invoves tightening or repairing the overstretched and damaged ligamnets, capsule and cartilage
The Bankart lesion is a specific injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable.
To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. This cuff of cartilage makes the shoulder joint much more stable, yet allows for a very wide range of movements (in fact, the range of movements your shoulder can make far exceeds any other joint in the body).
What is a Bankart Lesion?
When the labrum of the shoulder joint is torn, the stability of the shoulder joint is compromised. A specific type of labral tear is called a Bankart Lesion. A Bankart lesion occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients. The tear is to part of the labrum called the inferior glenohumeral ligament. When the inferior glenohumeral ligament is torn, this is called a Bankart lesion.
What happens after sustaining a Bankart injury?
Typical symptoms of a Bankart lesion include:
• A sense of instability
• Repeat dislocations
• Catching sensations
• Aching of the shoulder
Often patients will complain that they cannot “trust” their shoulder, fearing it may dislocate again.
How is the diagnosis of a Bankart lesion made?
Most young patients (under the age of 30) who sustain a shoulder dislocationwill sustain a Bankart lesion; therefore, there is a high suspicion of this injury whenever a patient dislocates their shoulder. On examination, patients will often have a sense their shoulder is about to dislocate if their arm is placed behind their head.
X-rays are sometimes normal, but they may show an injury to the bone called a Hill-Sachs lesion. This is a divot of bone that was injured when the shoulder dislocation occurred. A MRI may also be obtained in patients who are suspected of having a Bankart lesion. Bankart lesions do not always show up well on MRI scans. When a MRI is performed with an injection of contrast, a Bankart lesion is much more likely to be seen.
What is the treatment for a Bankart Lesion?
There are two general options for the treatment of a Bankart lesion. One option is to allow the arm to rest, and the inflammation to subside with the use of a sling. This is usually followed by physical therapy to regain motion of the extremity. The potential downside of this option is that people who dislocate a shoulder once are much more likely to dislocate the shoulder again.
The other option is to perform surgery to repair the torn labrum. When surgery is performed, the torn labrum of the Bankart lesion is reattached to the socket of the shoulder. The results of surgery are usually very good, with over 90% of patients returning to their activities without any further dislocations. More and more commonly this surgery is being performed arthroscopically; however, there are indications in some patients who should have a Bankart repair performed through a standard incision.