What is Bankart Repair?
The shoulder joint is a highly important joint in the human body that allows a person to perform various activities. Any inability that affects this joint can greatly affect a person's normal life. Various reasons like accidents, falls, or sports activity can cause pain and frequent dislocation in the shoulder joint. Bankart Repair is a surgery to restore a person's full use of the shoulder joint. It aims to treat the Bankart Lesion, which is the most common cause of pain and dislocation.
What are the Benefits Of Bankart Repair Treatment?
- Minimally invasive surgery for restoration of shoulder movement
- Arthroscopic bankart repair doesn't require any incisions and hence lesser stitching.
- There are only minor incisions, so patients heal much quicker than through open surgery.
- Rapid decrease in discomfort and faster return to work.
- There is less scarring with this operation.
- The procedure restores the function of the shoulder joint.
Who Needs Bankart Repair Treatment?
The Ideal Candidate For The Bankart Repair Treatment
- Play sports with a possibility of collision with other players resulting in dislocation of the shoulder joint.
- Have been involved in a motor accident that caused a sudden blow to the shoulder joint and dislocated it.
- Are involved in sports swimming, tennis, volleyball, etc. that need forceful and frequent movements of the shoulder joint resulting in tearing a part of the labrum.
- Who land on their shoulders and cause injury when doing activities like gymnastics, skating, rollerblading, skiing, etc.
- Work with tools like a hammer that will require powerful motion of the arms.
What May Happen if Bankart Repair is Delayed?
- If not repaired on time, bankart lesions can result in chronic shoulder instability, which means the ball will not be placed in the centre of the socket.
- Shoulder instability causes extreme pain and shoulder stiffness.
- If untreated for a long time, the shoulder can become completely immobile.
- Forceful movement of the shoulders results in dislocation.
- Untreated bankart lesions can even lead to osteoarthritis.
How is Bankart Repair Performed?
- The arthroscopic bankart repair is done under general anaesthesia. The nurses move the patient to the operating theatre to prepare for the surgery.
- Before administering anaesthesia, the patient is connected to machines that continuously check vital signs.
- This surgery is done either with the patient in a beach chair sitting position or lying on the side with the affected shoulder facing up.
- The anaesthetist gives anaesthesia to the patient while watching the vital signs.
- Arthroscopic bankart repair needs two incisions to be made on the shoulder near the joint.
- This procedure is done from the anterior side of the joint.
- The doctor inserts an arthroscope through one of the incisions to view the damage.
- Saline fluid is pumped through the instrument to get a clear view of the joint.
- Another instrument is inserted through the second incision to repair the torn ligament.
- Bone anchors are placed at various spots on the glenoid rim. They have sutures attached to them.
- The sutures in the anchor are used to pull the labrum up and secure it back to its original position at places where it is torn.
- Capsules that are elongated due to the shoulder dislocation are sutured to the anchors helping to tighten the shoulder joint further.
- Once the repair has been completed, doctors suture both incisions.
- The whole procedure takes about an hour to complete.
- After completion of the surgery, patients are moved to the recovery room.
What to Expect Before Bankart Repair?
- Doctors conduct a physical test when a patient complains of extreme pain or difficulty in movement of the shoulders.
- Those with dislocated shoulders are sent for MRI scanning, which will show the specialist the extent and area of damage.
- The surgeon may also use X-ray imaging to see if there are any bony lesions.
- Specialists enquire with patients regarding their lifestyle and health issues.
- Patients inform the doctor about the medicines they regularly take.
- The surgeon will inform the patient about the nature of the surgery and how long it will take for recovery.
- Doctors also inform the patient about the cost of the procedure. The price for this operation in India ranges from Rs. 1,20,000 to 1,50,000.
- Patients also get to know the care they must take after the surgery and how long it takes for complete recovery.
What to Expect On The Day Of Bankart Repair Surgery?
- Patients must refrain from eating anything from midnight of the night previous to the surgery.
- Preparations for the surgery, like removal of hair and cleaning of the area, are done in the morning.
- Nurses check the patients' vital signs before taking them to the operation theatre.
- The patient and the nearest kin must sign consent forms agreeing to the operation.
- Patients must remove their clothes and wear hospital gowns. They must remove all jewellery and other accessories.
- Nurses take the patient to the operation theatre for further proceedings.
What Happens During Bankart Repair?
- Specialists measure the vital signs of the patient.
- Antibiotics are administered to prevent infection.
- IV fluids are given during the surgery.
- The patient is laid in a position that helps the doctor approach the surgery area more easily.
- An anaesthetist checks the vital signs and administers general anaesthesia.
- The specialist makes an incision once the patient is completely unconscious.
- Specialists use the incision to introduce an arthroscope that helps them view the affected area more clearly.
- The doctor views the torn ligament and decides what portions must be repaired.
- Another incision is made for the introduction of the instrument for fixing the bone anchors and suturing the torn portions of the labrum to the glenoid.
- Specialists will suture the capsules that are damaged due to he
- The doctor checks if there is damage to any other portion of the shoulder joint before closing the incision.
- Assistants move the patient to the recovery room.
- A drainage tube is attached to some patients for removing excess fluid.
How is Recovery and Post Op Care After Bankart Repair?
Recovery At The Hospital
- The patient wakes up from anaesthesia in the recovery room.
- Nurses will monitor the vital signs of the patient continuously.
- An immobilising sling is tied around the operated arm to restrict movement.
- A physiotherapist will advise patients about what exercises they can perform to regain full mobility of the shoulders.
- Doctors advise pain-relief medicines.
- Most patients can leave the hospital the next day.
- The drainage tube is removed the day after surgery, before the patient leaves for home.
Recovery At Home
- The immobilising sling must be worn for four weeks, continuously removing them only at times of bath.
- Exercises for strengthening the muscles with limited motion are done during this period.
- Patients can remove the dressing after two days and apply an adhesive bandage to the operated area.
- Applying ice packs on the shoulder for about 20 minutes 3 - 4 times a day will help in reducing swelling.
- After four weeks, patients can remove the sling and wear them only at night.
- At the end of six weeks, patients can start full-motion physiotherapy exercises.
- Most patients get back full mobility at the end of 12 weeks.
- Physiotherapy at home will suffice for almost all patients.
- Patients who do desk jobs can return to work after a week. Those needing physical activity may need to keep off work for about 4-6 months.
Follow Up Appointment
- The first follow-up visit will be between 8-10 days after the operation
- During the first visit, the sutures are removed, and the doctor examines the area for any infection.
- The doctor advises the patient about returning to work and physiotherapy during this visit.
- The patient is asked to visit the doctor after two or three weeks to check the mobility of the shoulder.
- Patients must plan to make repeat visits at 6, 12 and 24 weeks after the operation.
Risks And Complications
- Infection can result from the surgery.
- Some patients suffer from bleeding.
- Occurrence of injury to blood vessels or nerves.
- Shoulder instability may recur in some cases
- Post-traumatic arthritis is another risk.