Labral (Bankart) Repair for Instability
Shoulder Surgery - Adelaide Orthopaedic Specialist
Labral or bankart tears can be repaired via surgical intervention. Dr James McLean is able to provide this procedure using a minimally-invasive arthroscopic approach.
What is a Bankart lesion?
A Bankart lesion is a type of labral tear which occurs in the lower/front region of the labrum – the ring of cartilage which surrounds the shoulder socket. If left unrepaired, the patient will likely experience future pain and dislocation (chronic shoulder instability).
What causes Bankart lesions?
Bankart lesions may occur following an anterior shoulder dislocation (when the shoulder is pushed backward and out of its natural position). As this is the most common type of shoulder dislocation, Bankart lesions are a relatively common injury.
Anterior shoulder dislocation may be caused by traumatic impact which pushes the shoulder backwards, such as blows from sport or a car accident. It may also result from a fall to an outstretched arm. Overuse can gradually weaken the ligaments which hold the joint in place, making it susceptible to instability and dislocation.
Bankart lesion management
Bankart lesions will often heal on their own, although they may not heal in the right position without intervention. Many cases will require surgery to attach the torn labrum to the shoulder socket, particularly in younger patients who intend to remain active.
Conservative management
In the conservative management of Bankart lesions, emphasis is placed on strengthening the joint’s dynamic stabilisers to prevent recurring injury. This may be achieved through physiotherapy and specialised exercises.
Following the initial relocation of the joint and immobilisation for several weeks, specialised exercises will be recommended to target and strengthen the shoulder muscles. Dr James McLean can provide recommendations for non-surgical approaches and refer to experienced physiotherapists for ongoing care.
Surgical repair – arthroscopic Bankart lesion repair
Bankart tears are typically repaired via shoulder arthroscopy. Dr James McLean generally performs this procedure via arthroscopy.
Arthroscopic Bankart lesion repair takes place under general anaesthetic. Dr James McLean inserts a tiny camera through a small incision in the joint, which allows him to fully inspect the area before applying corrective measures.
Small, specialised instruments are then inserted through another incision, allowing Dr McLean to repair the damage at the exact site of the injury. Tears in the cartilage are repaired with tiny sutures, and damaged tissue is removed.
The tools are removed from the surgical site, the small access incisions are stitched closed, and dressings are applied to the wounds.
Recovery from arthroscopic Bankart lesion repair
You will generally be required to wear a sling for the subsequent 4-6 weeks post-procedure.
This allows the tear to heal with minimal disruption. Following this rest period, you may begin to resume normal activities under guidance from your surgeon.
Your own recovery process will be highly dependent on your individual health and needs. Dr James McLean will also prescribe an individualised rehabilitation plan to improve shoulder strength and range of motion following your Bankart lesion repair.
Shoulder Conditions
Browse the links below for more information on specific shoulder conditions, including the main causes, symptoms and treatments.
Shoulder Arthritis
Shoulder arthritis can cause deep joint pain, stiffness, grinding and reduced movement. It may affect the main ball and socket joint or the smaller AC joint at the top of the shoulder. Treatment could include physiotherapy, medication, injections and surgery.
Shoulder Instability
A shoulder that repeatedly slips, gives way or dislocates may have chronic instability. This can develop after a previous dislocation or from loose supporting tissues. Treatment may include rehabilitation or surgery based on the injury and level of instability.
Shoulder Fractures
A shoulder fracture can involve the upper arm bone, collarbone or shoulder blade. Falls, sports injuries, cycling accidents and direct impacts are common causes. Some fractures heal with a sling and rehabilitation, though displaced or unstable fractures may require surgery.
Frozen Shoulder
Frozen shoulder causes progressive pain and stiffness as the capsule around the shoulder joint tightens. Daily tasks such as dressing, washing your hair or reaching behind your back become difficult. Treatment may include physiotherapy, injections or hydrodilatation, and surgery.
Shoulder Replacement
Shoulder replacement is considered for severe arthritis, some complex fractures or shoulder damage linked with a poorly functioning rotator cuff. Different forms of replacement are used for different shoulder problems, including anatomic and reverse shoulder replacement.
Shoulder Dislocation
A shoulder dislocation happens when the upper arm bone moves out of the socket, usually during sport, a fall or other traumatic injury. After the shoulder is relocated, further review may be needed to assess ligament, labral or bone damage and the risk of another dislocation.
Rotator Cuff Injuries
The rotator cuff is a group of muscles and tendons that helps lift and rotate the arm. Problems can include tendinitis, bursitis and partial or full-thickness tendon tears. Common signs include pain when raising the arm, weakness, difficulty reaching behind your back and pain when lying on the affected shoulder.
Bursitis and Impingement
Bursitis and impingement can cause pain around the front or side of the shoulder, especially when lifting the arm overhead or sleeping on the affected side. Non-surgical treatments are guided, though shoulder arthroscopy may be discussed for cases where symptoms continue.
Shoulder Treatments and Surgery
Surgical Shoulder Procedures and Treatments
Surgery may be discussed if symptoms remain limiting, there is significant damage or an injury needs repair. Procedures performed for shoulder conditions can include:
- Arthroscopic keyhole surgery
- Arthroscopic debridement
- Subacromial decompression (acromioplasty)
- Rotator cuff repair
- Labral or Bankart repair
- Biceps tenodesis or tenotomy
- AC joint excision
- Capsular release
- Tendon transfer
- Shoulder stabilisation surgery
- Fracture fixation
- Shoulder replacement
If Dr James McLean recommends a procedure, this will be based on the condition, examination and imaging findings and explained clearly before any decisions need to be made.
Non-Surgical Shoulder Treatments
Many shoulder conditions do not need surgery. Non-surgical treatment may include:
- Activity changes
- Physiotherapy and rehabilitation
- Medication where suitable
- Corticosteroid injections
- Hydrodilatation for frozen shoulder
- Manipulation under anaesthesia (MUA) for frozen shoulder
- Monitoring and repeat imaging
Common Shoulder Injuries
Browse the links below for more information on common shoulder injuries, including the main causes, symptoms and treatments.
Biceps Tenotomy
A procedure to relieve pain by releasing the long head of the biceps tendon from its attachment to the shoulder.
Suprascapular Nerve Release
Surgical relief of nerve compression in the shoulder to alleviate pain and restore function.
Labral (Bankart) Repair for Instability
Reconstructive surgery to address shoulder dislocation by repairing the torn labrum.
Subacromial Decompression
A minimally invasive surgery to increase space in the shoulder joint, easing movement and reducing pain.
Post-Operative Shoulder Exercises
Tailored rehabilitation activities designed to strengthen the shoulder and improve the range of motion after surgery.
Biceps Tenodesis
Surgically anchoring the biceps tendon to a stable location to alleviate symptoms associated with tendon tears or inflammation.
Latarjet Procedure for Instability
A surgical technique that transfers a piece of bone to the shoulder socket, providing stability and preventing dislocation.
Shoulder Arthroscopy – Acromioclavicular Joint Excision
Key-hole surgery to remove a small piece of the clavicle, relieving pain from arthritis or impingement.
Shoulder Arthroscopy – Animation
Visualisation technique using animation to demonstrate how arthroscopic shoulder surgery is performed.
Shoulder Arthroscopy – SLAP Repair
Repair of a SLAP lesion, which is a tear of the rim of the shoulder socket where the biceps tendon attaches.
Tendon Transfer for Massive Rotator Cuff Tears
Reconstructive surgery where a tendon is transferred to compensate for irreparable rotator cuff damage.
Scapulothoracic Arthroscopy
Depending on the type and severity of your shoulder injury, surgery might be the best option. Dr James McLean specialises in minimally invasive arthroscopic (key-hole) surgery. His aim is to get you the best possible outcome, taking into account your lifestyle, general health and family situation. Before surgery, Dr McLean will guide you through the process and address any concerns you have.
If you have a sports injury or other shoulder condition, it is best to act quickly. Delaying treatment can cause permanent damage and reduce the potential for a full recovery.
Call our friendly team on 08 7077 0101 to make an appointment or use our handy online booking service. Consultations are available in Dulwich (SA), Bedford Park (SA) and Elizabeth Vale (SA).
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