Arthroscopic Stabilization/Bankart Repair
Instability of the shoulder joint is a condition in which the ball slides out of the joint outside of its normal physiologic movement. This may occur partially (subluxation) or completely (dislocation). The joint is supported by many factors including the ligaments of the joint capsule, the labrum (a rim of cartilage around the cup), the muscles around the shoulder (rotator cuff) and other factors. Instability is more common in the younger athletic patient but can occur at any age.
When operative treatment is indicated arthroscopic techniques are typically used to stabilize the shoulder. The majority of these procedures are able to be performed arthroscopically, which is Dr. Lenarz’s preferred option. These surgeries include:
These arthroscopic procedures can be done at the hospital or an outpatient surgical center. Through very small incisions, Dr Lenarz inserts small instruments into the shoulder including a camera. The entire shoulder is inspected under direct visualization with this camera and any damage that may not have been noted on an MRI will be addressed appropriately.
The majority of these procedures are able to be performed arthroscopically, which is Dr. Lenarz’s preferred option. These surgeries include:
Occasionally open surgical techniques are required for treatment of instability. This is usually necessary when there is significant bony damage. This usually occurs when there repetitive dislocations wearing increasing amounts of the bone from the glenoid (cup) and humeral head (ball). These surgeries include:
Surgery for instability and Bankart injuries is a simple arthroscopic procedure. This usually involves tightening of the capsule (capsulorraphy) as well as a repair of the labrum (Bankart). This is done using anchors that are put into the bone at the rim of the cup (glenoid) where the labrum has torn. This is typically performed as an outpatient surgery. The most difficult part of the repair for the patient is the period of recovery, the initial immobilization and eventual progression of range of motion and strengthening. Failure to follow these recommendations and their timeline increases the risk of the repair being pulled away from the glenoid so it is unable to heal back to the bone. This increases the risk or recurrence and further joint pain.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the shoulder should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing may be removed and the patient may shower the day following surgery. The patient is asked to NOT scrub the incisions but allow water to wash over them and to be sure to call with any questions.