This document describes the arthroscopic Bankart repair procedure for a 26-year-old male patient with recurrent right shoulder instability. An MRI showed a Bankart lesion and Hill-Sachs lesion. During the arthroscopic procedure, the Bankart lesion extending from the 2 to 5 o'clock position on the glenoid was repaired. Post-operatively, the patient's arm was immobilized for 3 weeks followed by a rehabilitation program. Arthroscopic stabilization allows for a complete inspection of the joint and treatment of all intra-articular lesions while preserving range of motion.
2. History
26 yrs old male , Right handed individual , computer
programmer by profession , recreational sportsman ,
presented with Recurrent episodes of instability of
Right shoulder for 6yrs.
Episodes 10/year. Last episode 1 week back.
Treated with CR.
3. History
Tenderness anterior aspect . Wasting of Deltoid ,
Positive Hamilton ruler test. All ROM restricted and
painfull . Apprehension present . No evidence of
multidirection, sulcus sign present.
MRI done– Bankart’s lesion. Posteromedial
Hillsach’s lesion.
9. Post-operative Radiogram
Immobilisation in
arm sling for 3
wks. Passive and
active assisted at
3 wks. Abduction
only to 90. No ER.
At 6 wks full Rom
and rotator
strengthening.
10. Advantages of Ascopic stabilisation.
Smaller skin incisions.
Complete inspection of joint.
Ability to treat all intraarticular lesions.
Ability to access all areas of GH joint.
Less soft tissue dissection.
Preservation of ER.
11. T.Neviaser identified ALPSA(anterior
labroligamentous periosteal sleeve
avulsion) in anterior-inferior GH instability.
High failure rates in previous ascopic
repairs due to technical factors- medial
repair of anterior labrum.
failure to treat ALPSA, SLAP, rotator
interval, capsular tensioning.
12. Neer’s concepts
GH instability in multiple directions
Correction of all 3 symptomatic directions
is necessary.
Scoring systems used- American shoulder
and elbow surgeons shoulder index ,
constant scoring systems.
13. Indications- persistant shoulder pain from
GH instability that has not responded to 6
mnths of non-opretive treatment.
Factors to be considered; age, severity of
initial trauma, reduction method, arm
dominance, activity level, sports , desired
level of activity, instability, radiographic
finding’s.
14. Contraindications- who demonstrate GH
instability , voluntary muscular contractions ,
emotional instability, Glenoid defects more
thyan 4 mm.
Hill-S-sach’s lesion engaging the anterior
Glenoid.