Superior labrum lesion from anterior to posterior in the shoulder. Petterson, phd anterior instability treated by arthroscopic surgery is a viable option to return the athlete. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 0. No passive forceful stretching into external rotationextension for 3 months following an anterior repair and into internal rotation for a posterior repair. Arthroscopic anterior bankart repair rehab protocol. Complications after arthroscopic labral repair for shoulder instability. Bankart repair rehabilitation protocol arthroscopicopen this protocol was developed for patients who have had a bankart repair. Patients with additional surgery will progress at different rates. Immediate postop through 4 weeks post op therapist assisted passive range of motion prom ok immobilize full time except pendulums and stick assisted external. Pdf the purpose of this study was to evaluate the results in. Feb 02, 2015 arthroscopic transosseous bony bankart repair performed in a right shoulder in the lateral decubitus position. May remove for dressing, hygiene, and tabletop use of hand, wrist, or elbow. Pdf arthroscopic repair of primary anterior dislocations of. Arthroscopic labral repair is a widely performed and safe technique for anterior or posterior shoulder instability.
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. Bankart repair, arthroscopic open revised august 2008 postop days 1 7 sling x 6 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist active motion arom with shoulder in neutral position at side supported pendulum exercises. Arthroscopic bankart repair with suture anchors tips for success. Arthroscopic stabilisation bankart repair this procedure involves repairing the over stretched or torn labrum and capsule deep within the shoulder joint. Bankart repair rehabilitation protocol arthroscopicopen. During a procedure called a bankart repair, the damaged labrum is reattached to the glenoid, recreating the bumper that prevents the humeral head from slipping out. Arthroscopic bankart repair is a procedure is used to repair a detached or overstretched labrum and capsule deep within the shoulder joint.
Mar 28, 2016 intraoperative recording with 3 different cameras of a bankart repair operation, performed arthroscopically. Avoid any internal rotation of the glenohumeral joint. Traumatic glenohumeral bone defects and their relationship to. Arthroscopic bankart repair rehabilitation guidelines. Jan 11, 20 arthroscopic repair of this instability is the procedure of choice now a days. This technical description and video present a modern arthroscopic technique for bankart repair used at our institution with high success in an athletic population. Traumatic glenohumeral bone defects and their relationship. Pdf recovery of shoulder rotational muscle strength after. Arthroscopic capsulorraphy posterior bankart repairs rehabilitation protocol week 0 4 shoulder sling and swathe or abduction brace full time day and night.
Essential to the success of the arthroscopic bankart repair is protection of the capsule and static stabilizers of the glenohumeral joint. Arthroscopic slapbankart repair protocol andrea saterbak, md. The doctors will discuss your individual surgery with you before the operation. Chattanooga, tn 423 6242696 postoperative instructions you will wake up in the operating room. Brady performs an arthroscopic knotless bankart repair and discusses the benefits of using an interconnected knotless suturebridge technique for insetting the infraspinatus into the hill.
We prefer to perform the surgery arthroscopically keyhole, but some surgeons prefer an open procedure. Intraoperative recording with 3 different cameras of a bankart repair operation, performed arthroscopically. It lines the shoulder socket and helps keep the ball of the humerus in place. Bankart repair using modern arthroscopic technique. Arthroscopic bankart repair manhattan orthopedic care. The pushlock anchor is designed for simple and secure arthroscopic glenohumeral joint instability repair. Modified rowe scores improved from 25 preoperatively to 84.
The anchor provides the ability to independently pass the suture through a desired. The arthroscopic bankart repair progresses more conservatively than an open procedure due to fixation methods that initially postop may not be as stable. Arthroscopic bankart repair and remplissage scoi technique 2015 feat. Aerobic conditioning throughout the rehabilitation process. The objective of this article is to show a new technique for arthroscopic bankart repair without using suture anchors to decrease the surgery cost level and reduce operative time. Pdf background shoulder rotational muscles act as dynamic stabilizers of the glenohumeral joint, and the recovery of muscle. Rate of progression based on evaluation of the patient no excessive er, extension or elevation. Arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note. Labral repair surgery involves reanchoring and suturing or trimming away the. Location is the same as described for bankart repair. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus ball and the glenoid portion of the scapula socket. The bankart procedure has been the surgery of choice in the united states for repair of anterior shoulder instability in noncontact athletes.
Shoulder dislocation and bankart repair desio sports. Rate of progression based on evaluation of the patient no excessive er, extension or elevation continue isometrics and rhythmic stabilization submax core stabilization program. Arthroscopic bankart repair center for sports medicine. 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 operation involves reattachment and tightening of the torn labrum and ligaments of the shoulder see pictures below. The labrum is a thick band of cartilage attached to the glenoid. Open latarjet procedure for failed arthroscopic bankart repair.
Dr joe burns performs an arthroscopic reduction and repair of a displaced glenoid fracture after traumatic dislocation. Arthroscopic posterior bankart repair tmi sports medicine. Arthroscopic repair of this instability is the procedure of choice now a days. An anterior inferior portal created just superior to the lateral subscapularis tendon, using a threaded 7 or 8. A bankart lesion is a shoulder injury that occurs due to a labrum tear causing instability and recurrent dislocations of the shoulder joint. Technical advances, plus an end to worrisome recurrence rates, make arthroscopic stabilization the procedure of choice. Setup and positioning we perform shoulder arthroscopy with the patient on a bean bag in the lateral decubitus position because we feel this provides optimum exposure for instrument place ment and allows for distraction of the glenohumeral. It has been demonstrated here in association with smith and nephew inc. Arthroscopic bankart repair the socket of the shoulder, or glenoid, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. Bankart repair surgery is a minimally invasive surgery to repair instability and restore function of dislocated shoulders. Arthroscopic bankart repair is reliable for this patient. The patients level of pain is not an accurate guage of healing and need for progression immediately post operative the patient will be placed in an immobilizer for four weeks. This arthroscopic shoulder surgery is used to repair a detached labrum.
You can get the wound wet after 2 days in a shower, but do not soak in a tub. The bankart repair for shoulder instability has evolved from open reconstruction to minimally invasive arthroscopic techniques, which have the benefit of less pain and morbidity. The critical point to to keep the shoulder muscles loose and relaxed. The humeral head ball of the shoulder joint is centered in the glenoid the socket of the joint, which stabilizes the shoulder. Arthroscopic bankart repair is a minimally invasive surgical procedure performed to reattach and tighten the detached labrum within the shoulder joint. On these basics, a decision to perform bankart repair was made. Arthroscopic bankart repair is an ideal method of stabilization in patients with an injury to the inferior labrum without significant osseous injury large bony bankart or hs lesion. Overview and recovery from a patients perspective doug letourneau is an avid basketball player in his free time. Arthroscopic repair of bony bankart fracture vumedi. Bankart repair using modern arthroscopic technique ncbi. Arthroscopic bankart repair in plano, frisco, mckinney and.
Arthroscopic repair of chronic bony bankart lesion using a. The suture first technique allows surgeons to independently pass suture through a desired amount of tissue prior to anchor. Arthroscopicopen anterior bankart repair physical therapy. Er supine or standing wand to within 15 degrees of opp shoulder ir as tolerated wand behind back not if open bankart pushup plus against wall no elbow flexion 90 degrees prone scapular retraction exercises without weights treadmill walking progression program. When the shoulder joint is torn its common to have occurred due to a shoulder dislocation and instability. Modified arthroscopic bankart repair successfully returns contact athletes to sport.
Traumatic injuries and repetitive overhead shoulder movements can tear the labrum, leading to pain, limited motion, instability and weakness in the joint. This portal can be used for anchor placement for slap lesions with a significant anterior extension and for suture management during repair of posterior slap lesions. The large bony bankart fragment is mobilized, and 2 tunnels are drilled through the fragment from posterior to anterior using a 0. By san diego shoulder institute 2016 featuring jeffrey s. Arthroscopic bankart repair for anterior shoulder instability. After the camera is inserted into the joint, the operator can see the damage inside the structures.
Restrictive motion goals weeks 02 week 2 weeks 34 weeks 56 1. A rich description and comments help to understand every step. Outcomes of arthroscopic repair of bankart lesions are favorable. Arthroscopic surgery is usually performed as a day case procedure. The arthroscope uses a tiny camera to project a picture of your affected area onto. The arthroscopic technique involves identifying and repairing all pathology that contribute to glenohumeral instability, i. Shoulder stabilisation surgery sheffield teaching hospital. Pdf arthroscopic repair of primary anterior dislocations. Brady, md, knoxville, tn discusses the arthroscopic bankart repair and knotless remplissage by presenting a case study of glenohumeral instability with repair portal placement posterior viewing portal. The bankart repair for shoulder instability has evolved from open reconstruction to minimally invasive arthroscopic techniques, which have the.
Pdf arthroscopic bankart repair using suture anchors in athletes. Arthroscopic slapbankart repair protocol andrea saterbak, md phase i. To better understand what a bankart tear or lesion is, an overview of the shoulder is needed. Remove the outer dressing on the second day after surgery and shower. This usually done using sutures and small bone anchors.
Netto et al 8 reported the results of a randomized controlled trial of 50 adult patients under 40 years of age with traumatic anterior shoulder instability and the presence of an isolated bankart lesion confirmed by diagnostic arthroscopy, randomly assigned to receive open or. Arthroscopic slapbankart repair protocol andrea saterbak. Arthroscopic rotator cuff repair rehabilitation guidelines derek plausinis, masc, md, frcsc 0 to 6 weeks postop sling use. Do not even measure internal rotation at the time of initial evaluation. Arthroscopic bankart repair using suture anchors sciencedirect. Arthrex arthroscopic bankart repair with knotless remplissage. Arthroscopic bankart repair with suture anchors tips for. The knotless technique saves valuable time and eliminates the possibility of knot impingement. Rehabilitation after arthroscopic posterior bankart repair. Arthroscopic stabilisation bankart repair shoulderdoc. Arthroscopic bankart repair with knotless remplissage. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair 333 38th st. After all these steps, we are walked through the rest of the procedure. Sisto 25 presented a series of 30 patients with a failed arthroscopic bankart repair treated with a traditional, open bankart repair.
Arthroscopic bankart repair for the management of anterior. Both authors performed an identical arthroscopic bankart repair using a variety of metallic suture anchors. Although complete examination of the joint is required for all shoulder procedures, this article only discusses our technique for treatmentof traumaticanterior shoulderinstability. Nine of these 21 patients were contact athletes all rugby players. The arthroscopic bankart repair using the suture anchor is not indicated in multidirectional instability. Arthroscopic bankart repair surgery northam shoulder.
May have sling and swathe brace off four times daily for active hand, wrist, and elbow rom. Arthroscopic transosseous bony bankart repair performed in a right shoulder in the lateral decubitus position. Pdf arthroscopic repair of posterior bony bankart lesion. Complications associated with anterior shoulder instability repair. Arthroscopic anterior bankart repair phase i immediate postoperative phase. Achieving the criteria of each phase should be emphasized more than the approximate duration. Arthroscopic posterior bankart repair in the beach chair position feat. Shoulder dislocation and bankart repair sports medicine. Overall, when performed for the correct indications, arthroscopic repair results in a low risk for recurrent instability and a high return to sport or work. Good posture is critical throughout the rehabilitation process to improve healing and decrease the risk of developing poor mechanics. He also shares valuable surgical pearls and the evolution of his technique for managing hill. 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 socket portion of the joint is not naturally deep.
Arthroscopic bankart repair this procedure accesses the front of your shoulder by inserting a thin, flexible tube called an arthroscope through a small incision. Pdf posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Matthew crawford this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure. When he dislocated his shoulder during a game, he wanted to treat his injury as quickly as possible and get back on the court.
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