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. Recurrence rates of instability are acceptable and reoperation rates were low. During arthroscopic bankart repair, penetration of suture anchors through the far cortex can compromise the initial biomechanical characteristics of anchor stability and repair integrity. Arthroscopic bankart repair this protocol to be used for laterjet procedures as well dr. The bankart procedure is performed to increase anterior stability of the shoulder. Open latarjet surgery is a good option for failed arthroscopic bankart repair. Passive pendulums to warmup passive range of motion no internal rotation week 1 to 3 supine external rotation. It is not intended to be a substitute for ones clinical decision. Arthroscopic stabilisation bankart repair this procedure involves repairing the over stretched or torn labrum and capsule deep within the shoulder joint. Primary arthroscopic bankart repair with remplissage shows low failure rate. Dr joe burns performs an arthroscopic reduction and repair of a displaced glenoid fracture after traumatic dislocation. Matthew crawford this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure. This arthroscopic shoulder surgery is used to repair a detached labrum. Arthroscopic repair of chronic bony bankart lesion using a.
Arthroscopic revision bankart repair can be an effective alternative, but should only be considered in the properly selected. General information there may be a loss of external rotation when compared to the other side, but the motion is. Arthroscopic stabilisation bankart repair shoulderdoc by. Glenoid shoulder joint before reconstructive surgery detached labrum sutures anchor sutures glenoid detached labrum shoulder joint sutures glenoid reattached. This study shows arthroscopic bankart repair with knot less anchors for recurrent anterior glenohumeral instability is a useful and succesful procedure. Arthrex arthroscopic bankart repair with knotless remplissage. When he dislocated his shoulder during a game, he wanted to treat his injury as quickly as possible and get back on the court. To better understand what a bankart tear or lesion is, an overview of the shoulder is needed. Arthroscopic bankart repair is commonly utilized for shoulder stabilization in patients with anterior shoulder instability. Arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note.
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. Bony bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Arthroscopic slapbankart repair protocol andrea saterbak. Each phase is adaptable based on the individual and special circumstances. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair 333 38th st. The arthroscopic technique involves making three small incisions and using a camera to see inside the shoulder joint.
Glenoid bone defects of less than 25% with an offtrack hillsachs lesion, however, should receive an arthroscopic bankart repair in addition to a remplissage. 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 most appropriate in the setting of a simple bankart lesion without significant glenoid bone loss gbl. Bankart repairanterior capsulorrhaphy rehabilitation. 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. When arthroscopic bankart repair is no longer a viable option for. Although there are no defined guidelines, small bony bankart fractures are typically treated arthroscopically with suture anchors. With the number available, no significant difference could be detected in the outcome between the types of the primary surgery. Arthroscopic bankart repair rehabilitation guidelines. American shoulder and elbow scores significantly improved with these procedures, researchers said. Pdf arthroscopic repair of posterior bony bankart lesion. This analogy is used because the articular surface of the round humeral head upper most part of the. Arthroscopic panlabral repair with remplissage of hillsachs. The arthroscope uses a tiny camera to project a picture of your affected area onto a screen for your orthopedic surgeon to see.
Arthroscopic bankart repair this procedure accesses the front of your shoulder by inserting a thin, flexible tube called an arthroscope through a small incision. Apply ice to the shoulder as tolerated to reduce pain and swelling. Original article arthroscopic versus open bankart repair in patients. Bankart repair protocol vanderbilt university medical center. Recurrent anterior shoulder instability, bankart, arthroscopy.
It is designed for rehabilitation following arthroscopic bankart repair anterior capsulorrhaphy procedure. 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. Anterior shoulder reconstruction with arthroscopic bankart repair. Biomechanical studies have shown improved reduction and. The humeral head ball of the shoulder joint is centered in t. Risk factors for recurrence of anteriorinferior insta bility of the shoulder after arthroscopic bankart. It lines the shoulder socket and helps keep the ball of the humerus in place. The arthroscopic bankart repair progresses more conservatively than an open procedure due to fixation methods that initially postop may not be as stable. Arthroscopicopen anterior bankart repair physical therapy.
Pdf arthroscopic bankart repair for the management of anterior. Bankart repair surgery is a minimally invasive surgery to repair instability and restore function of dislocated shoulders. The labrum is a thick band of cartilage attached to the glenoid. The following is a guideline for progression of postoperative treatment. Arthroscopic slap bankart repair protocol andrea saterbak, md phase i. Arthroscopic anterior stabilization with or without bankart repair. The full text of this article is available in pdf format. Guidelines for weeks 0 to 6 draft university of washington.
Arthroscopic bankart repair twin cities orthopedics. Overview and recovery from a patients perspective doug letourneau is an avid basketball player in his free time. Arthroscopic bankart repair manhattan orthopedic care. Arthroscopic bankart repair in plano, frisco, mckinney and. Muscle strength after anterior shoulder stabilization. The authors declare that they have no conflicts of interest concerning this article. Arthroscopic bankart repair for anterior shoulder instability. If procedure is performed arthroscopically strengthening of the rotator cuff. Although open bankart repair is more invasive than the. Open latarjet procedure for failed arthroscopic bankart repair. The critical point to to keep the shoulder muscles loose and relaxed.
Rehabilitation after arthroscopic posterior bankart repair. This can be done surgically with an arthroscopic technique or an open technique. Bankart repair anterior capsulorrhaphy rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. 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. Pdf chapter05 arthroscopic bankart repair researchgate. Arthroscopic posterior bankart repair tmi sports medicine. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 0. Immediately postoperatively, exercises must be modified so as not to place. The functional results of arthroscopic bankart repair with knotless. Arthroscopic revision bankart repair did not result in any additional loss of external rotation compared with the contralateral side p. 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. Move your elbow, fingers and hand several times a day.
Rate of progression based on evaluation of the patient no excessive er, extension or elevation. Technical advances in arthroscopic instability repair have led to outcomes approaching those of open surgical repair. Oct 24, 2015 arthroscopic orthopedic surgical video of bony bankart stabilization of anteriorinferior glenoid fracture of the shoulder for traumatic shoulder dislocation from san francisco orthopaedic sports. If glenoid bone loss is less than 25% with an ontrack hillsachs lesion, arthroscopic bankart repair is capable of reliable outcomes. Arthroscopic bankart repair for the management of anterior. The arthroscopic technique involves identifying and repairing all pathology that contribute to glenohumeral instability, i. The 2 main techniques used are double and singlerow suture anchor stabilization, with debate over superiority. Do not even measure internal rotation at the time of initial evaluation.
Preserve the integrity of the surgical repair restore muscular strength and balance enhance neuromuscular control range of motion week 8 external rotation. 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. Manual reduction of the joint was carried out by hippocrates or rowe technique at. 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. Primary arthroscopic bankart repair with remplissage shows. Arthroscopic repair of bony bankart fracture vumedi. The torn tissue is identified then suture anchors or bioabsorbably tacks are. 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 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. Avoid any internal rotation of the glenohumeral joint. You can change the dressing to a smaller one to allow the cold therapy to reach the shoulder. When the shoulder joint is torn its common to have occurred due to a shoulder dislocation and instability.
Revision open bankart surgery after arthroscopic repair for traumatic anterior shoulder instability. Click here to download pdf rehabilitation after arthroscopic posterior bankart repair. 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. Chattanooga, tn 423 6242696 postoperative instructions you will wake up in the operating room. 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. Modified arthroscopic bankart repair successfully returns contact athletes to sport. Arthroscopic bankart repair is a procedure is used to repair a detached or overstretched labrum and capsule deep within the shoulder joint. Arthroscopic rotator cuff repair rehabilitation guidelines derek plausinis, masc, md, frcsc 0 to 6 weeks postop sling use. Arthroscopic bankart repair rehab protocol this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure. Manual reduction of the joint was carried out by hippocrates or rowe.
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