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