Arthroscopic repair of bankart injuries have good success rates, though nearly onethird of patients require further surgery for continued instability after the initial procedure in a study of young adults, with higher reoperation rates in those less than 20 years of age. During arthroscopic bankart repair, penetration of suture anchors through the far cortex can compromise the initial biomechanical characteristics of anchor stability and repair integrity. Pdf arthroscopic repair of posterior bony bankart lesion. Rehabilitation after arthroscopic posterior bankart repair. General information there may be a loss of external rotation when compared to the other side, but the motion is. Arthroscopic bankart repair with suture anchors tips for success. Nov 09, 2012 if a lesion of 20% to 30% the width of the glenoid is present, arthroscopic repair of the bony bankart lesion is preferable to repair of the softtissue lesion alone. The full text of this article is available in pdf format. It is designed for rehabilitation following arthroscopic bankart repair anterior capsulorrhaphy procedure.
Arthroscopic posterior bankart repair tmi sports medicine. Open latarjet procedure for failed arthroscopic bankart repair. You can change the dressing to a smaller one to allow the cold therapy to reach the shoulder. If glenoid bone loss is less than 25% with an ontrack hillsachs lesion, arthroscopic bankart repair is capable of reliable outcomes. Glenoid bone defects of less than 25% with an offtrack hillsachs lesion, however, should receive an arthroscopic bankart repair in addition to a remplissage. With the number available, no significant difference could be detected in the outcome between the types of the primary surgery. Manual reduction of the joint was carried out by hippocrates or rowe. Original article arthroscopic versus open bankart repair in patients. Pdf arthroscopic bankart repair for the management of anterior. Petterson, phd anterior instability treated by arthroscopic surgery is a viable option to return the athlete. We prefer to perform the surgery arthroscopically keyhole, but some surgeons prefer an open procedure.
Guidelines for weeks 0 to 6 what to do talk with your provider, nurse, or physical therapist if you have any questions or concerns. When he dislocated his shoulder during a game, he wanted to treat his injury as quickly as possible and get back on the court. Muscle strength after anterior shoulder stabilization. Overview and recovery from a patients perspective doug letourneau is an avid basketball player in his free time. Biomechanical studies have shown improved reduction and. Although open bankart repair is more invasive than the. Arthroscopic bankart repair for the management of anterior. It lines the shoulder socket and helps keep the ball of the humerus in place.
The 2 main techniques used are double and singlerow suture anchor stabilization, with debate over superiority. American shoulder and elbow scores significantly improved with these procedures, researchers said. Dr joe burns performs an arthroscopic reduction and repair of a displaced glenoid fracture after traumatic dislocation. Arthroscopic stabilisation bankart repair this procedure involves repairing the over stretched or torn labrum and capsule deep within the shoulder joint. Bankart repair protocol vanderbilt university medical center. Revision open bankart surgery after arthroscopic repair for traumatic anterior shoulder instability. Arthroscopic bankart repair this protocol to be used for laterjet procedures as well dr. Anterior shoulder reconstruction with arthroscopic bankart repair. Arthroscopic bankart repair this procedure accesses the front of your shoulder by inserting a thin, flexible tube called an arthroscope through a small incision. Arthroscopic rotator cuff repair rehabilitation guidelines derek plausinis, masc, md, frcsc 0 to 6 weeks postop sling use. It is not intended to be a substitute for ones clinical decision. Arthroscopic bankart repair twin cities orthopedics.
The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic anterior stabilization procedure. Arthroscopic bankart repair is commonly utilized for shoulder stabilization in patients with anterior shoulder instability. The cost implications and resource utilization of arthroscopic and open bankart procedures were evaluated to determine if differences exist between these procedures when performed in a community setting. The labrum is a thick band of cartilage attached to the glenoid. Arthroscopicopen anterior bankart repair physical therapy. To better understand what a bankart tear or lesion is, an overview of the shoulder is needed. Bony bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Arthroscopic bankart repair for anterior shoulder instability.
The following is a guideline for progression of postoperative treatment. This can be done surgically with an arthroscopic technique or an open technique. When the shoulder joint is torn its common to have occurred due to a shoulder dislocation and instability. Open latarjet surgery is a good option for failed arthroscopic bankart repair. Brady, md, knoxville, tn discusses the arthroscopic bankart repair and knotless remplissage by presenting a case study of glenohumeral instability with jan 11, 20 recurrent shoulder instability is due to the tear of anteroinferior glenoid labrum causing repeated shoulder dislocations which can be very painful. The functional results of arthroscopic bankart repair with knotless. Arthroscopic revision bankart repair can be an effective alternative, but should only be considered in the properly selected. Arthrex arthroscopic bankart repair with knotless remplissage. Each phase is adaptable based on the individual and special circumstances. If procedure is performed arthroscopically strengthening of the rotator cuff. Glenoid shoulder joint before reconstructive surgery detached labrum sutures anchor sutures glenoid detached labrum shoulder joint sutures glenoid reattached. When arthroscopic bankart repair is no longer a viable option for.
Recurrence rates of instability are acceptable and reoperation rates were low. Avoid any internal rotation of the glenohumeral joint. In more severe cases when the labrum is torn a portion of the glenoid may be fractured and this is referred to as bony bankart lesion. Arthroscopic slapbankart repair protocol andrea saterbak. Preserve the integrity of the surgical repair restore muscular strength and balance enhance neuromuscular control range of motion week 8 external rotation. The arthroscopic bankart repair progresses more conservatively than an open procedure due to fixation methods that initially postop may not be as stable. Our approach to the arthroscopic bankart uses the posterolateral portal described above in the technique section as the standard arthroscopic portals provide insufficient visualization and instrumentation access to the inferior. Arthroscopic bankart repair is most appropriate in the setting of a simple bankart lesion without significant glenoid bone loss gbl. Pdf chapter05 arthroscopic bankart repair researchgate. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee figure 1. Arthroscopic slap bankart repair protocol andrea saterbak, md phase i. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 0.
Bankart repairanterior capsulorrhaphy rehabilitation. Bankart repair surgery is a minimally invasive surgery to repair instability and restore function of dislocated shoulders. The humeral head ball of the shoulder joint is centered in t. Arthroscopic stabilisation bankart repair shoulderdoc by. Arthroscopic bankart repair rehabilitation guidelines. Click here to download pdf rehabilitation after arthroscopic posterior bankart repair. Recurrent anterior shoulder instability, bankart, arthroscopy. Arthroscopic revision bankart repair did not result in any additional loss of external rotation compared with the contralateral side p. Modified arthroscopic bankart repair successfully returns contact athletes to sport. Immediately postoperatively, exercises must be modified so as not to place. Immediate postop through 4 weeks post op therapist assisted passive range of motion prom ok immobilize full time except pendulums and stick assisted external rotation er to 30. The arthroscopic technique involves making three small incisions and using a camera to see inside the shoulder joint.
The critical point to to keep the shoulder muscles loose and relaxed. Arthroscopic bankart repair general sling and abduction pillow for six weeks avoid the throwing postion for three months most patients will not start formal physical therapy until three weeks postop phase i. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair 333 38th st. Although there are no defined guidelines, small bony bankart fractures are typically treated arthroscopically with suture anchors. Technical advances in arthroscopic instability repair have led to outcomes approaching those of open surgical repair. Guidelines for weeks 0 to 6 draft university of washington.
This study shows arthroscopic bankart repair with knot less anchors for recurrent anterior glenohumeral instability is a useful and succesful procedure. Arthroscopic repair of posterior bony bankart lesion and subscapularis remplissage article pdf available in arthroscopy techniques 63 june 2017 with 28 reads how we measure reads. Arthroscopic panlabral repair with remplissage of hillsachs. Passive pendulums to warmup passive range of motion no internal rotation week 1 to 3 supine external rotation. Rate of progression based on evaluation of the patient no excessive er, extension or elevation. Chattanooga, tn 423 6242696 postoperative instructions you will wake up in the operating room. The bankart procedure is performed to increase anterior stability of the shoulder. Arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note. Move your elbow, fingers and hand several times a day. Do not even measure internal rotation at the time of initial evaluation. A bankart lesion is the avulsion of the glenoid labrum, with or without a bony lesion, with the anterior band of the inferior glenohumeral ligament ighl from the.
Primary arthroscopic bankart repair with remplissage shows. Arthroscopic bankart repair in plano, frisco, mckinney and. This arthroscopic shoulder surgery is used to repair a detached labrum. Primary arthroscopic bankart repair with remplissage shows low failure rate. Manual reduction of the joint was carried out by hippocrates or rowe technique at. Arthroscopic bankart repair with suture orthopaedic foundation. This analogy is used because the articular surface of the round humeral head upper most part of the. Arthroscopic bankart repair manhattan orthopedic care. The authors declare that they have no conflicts of interest concerning this article.
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