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Bankart Lesion

Our shoulder joint is made up of humerus (ball) and the glenoid (socket). The socket of the shoulder (glenoid) is covered with a layer of cartilage (labrum) that helps stabilize the shoulder joint. Repetitive overhead shoulder movements or any other trauma can cause the labrum to tear. Labral tears are often described by their location. One of the most common labral injuries is the Bankart Lesion. It is named after English Orthopaedic Surgeon Arthur Sydney Blundell Blankart, who first described the injury and the surgical repair. It is also called Glenoid Labrum Tear. A bankart lesion occurs when the labrum at the bottom front of the glenoid gets torn from the cartilage and bone. This tends to happen when the shoulder dislocates anteriorly, that is the head of the humerus is popped forward out of the glenoid socket. Along with the labrum, if the bone is also damaged (fractured), it is called Bony Bankart Lesion. When the lesion to the labrum occurs simultaneously with a structural defect of the bone of the humeral head, it is called a Hill-Sachs Lesion.

Bankart Lesion – Causes

Bankart Lesion is common sports injury among athletes who play volleyball, football, handball, basketball, tennis, wrestling etc. It is also common among people who do repeated overhead activities like construction workers. Another cause of Bankart Lesion is trauma which causes forceful movement of the shoulder. It also commonly occurs in elderly people particularly woman, above 60 years due to falls.  Bankart Lesions are often caused by a shoulder dislocation, either partial or complete.

bankart lesion
bankart lesion

Bankart Lesion – Symptoms

Moderate to severe shoulder pain. Weakness and instability of the shoulder. Popping and clicking sensation when the shoulder is moved. Loss of range of motion of the shoulder. Repeated episodes of shoulder dislocation.

Bankart Lesion – Diagnosis

Your orthopaedic/shoulder doctor uses one or more of the following methods to diagnose a blankart injury:

    • Physical Examination
    • X-rays
    • MRI
    • Arthroscopy
    • MR arthrography
    • Radiographs (particularly for bony bankart lesions)

Bankart Lesion – Treatment Options

Depending on the severity and case of the Bankart Injury, there are two types of treatment options – surgical and non-surgical. If the bankart tear does not heal properly, it leads to further dislocations, instability and weakness of the shoulder.

Non-surgical treatment options

    • Rest and immobilization (with or without a sling)
    • Pain killers and Non-steroidal drugs (if the condition demands)
    • Physical Therapy
X Ray showing Bankart Lesion

Surgical Treatment:
Arthroscopic Bankart Reconstruction (or simply Bankart Repair Surgery)

Surgery is often opted for younger patients and who play sports as there is an elevated risk of recurring dislocations. Surgery is often opted for patients whose condition does not improve using standard non-surgical methods of treatment. The purpose of surgical correction of Bankart Lesion is to reattach the torn labrum to the socket of the shoulder thus restoring stability to the shoulder. In most of the cases, surgery is performed arthroscopically (key hole surgery) however in some cases, standard open incision is required. Arthroscopic surgery also has the advantage of less pain and faster recovery compared to open surgical method. Surgery is successful in most of the cases allowing them to return to regular activities without the incidence of recurring dislocation. Complications after a bankart repair surgery are very rare. However as with any surgical procedure, this surgery may develop some risk like bleeding, infection, shoulder stiffness, injury to blood vessel or nerve.

Bankart Lesion – Rehabilitation

Post surgery, patient will be advised to wear a sling for first few weeks. Almost immediately, he has to undergo a physical therapy program. Depending on the severity of the condition, patient will be advised to keep away from certain activities for some period of time.

In patients with increased risk of shoulder dislocations due to strenuous sports activities, they are advised to wear proper safety equipment. Elderly patients are advised to avoid any possible falls.

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