Understanding Labral Repair (Bankart / Arthroscopic Stabilization)
If you’ve experienced a shoulder dislocation, or if your shoulder often feels unstable and like it might pop out, your doctor might talk to you about a Labral Repair, often specifically a Bankart Repair, performed using Arthroscopic Stabilization. This surgery aims to fix a common injury inside your shoulder joint to help prevent future dislocations and restore stability.
What’s Going On with Your Labrum?
Your shoulder is a ball-and-socket joint. The “socket” part, called the glenoid, is actually quite shallow, like a golf tee. To help deepen this shallow socket and provide more stability for the “ball” (the head of your upper arm bone, or humerus), there’s a soft rim of cartilage called the labrum attached around the edge of the socket.
The labrum also serves as an anchor point for many of the ligaments that help hold your shoulder together.
A common type of labral tear that occurs after a shoulder dislocation is called a Bankart lesion (or Bankart tear). This happens when the labrum (and often some of the attached ligaments) tears away from the front lower part of the shoulder socket. When this tear occurs, the shoulder socket essentially becomes even shallower and less stable, making it much easier for the shoulder to dislocate again, especially in certain arm positions.
How Does Labral Repair (Bankart / Arthroscopic Stabilization) Help?
A Labral Repair, specifically a Bankart Repair, is a surgical procedure performed to reattach the torn labrum (and often the stretched ligaments) back to the bone of the shoulder socket. The goal is to restore the normal anatomy of the joint, deepen the socket, and provide much-needed stability to prevent future dislocations.
This procedure is typically performed arthroscopically, which means the surgeon uses small incisions (cuts) and a tiny camera (arthroscope) to work inside your shoulder joint. This minimally invasive approach often leads to:
- Smaller scars
- Less pain after surgery
- Potentially faster initial recovery compared to traditional open surgery
During the surgery, the surgeon will:
- Access the Joint: Small incisions (about the size of a buttonhole) are made around your shoulder.
- Visualize the Injury: The arthroscope is inserted, sending clear images of the inside of your joint to a video monitor. This allows the surgeon to see the torn labrum and any stretched ligaments.
- Repair the Labrum: Using tiny specialized instruments inserted through other small incisions, the surgeon will:
- Prepare the bone surface where the labrum tore away to encourage healing.
- Reattach the torn labrum back to the bone of the shoulder socket. This is typically done using small, bioabsorbable anchors (which dissolve over time) and strong sutures that firmly secure the labrum in place.
- If the shoulder capsule (the surrounding ligaments) is also loose or stretched, it may be tightened during the same procedure to further enhance stability.
Life After Labral Repair (Bankart / Arthroscopic Stabilization):
After your labrum repair, physical therapy is extremely important for a successful recovery and to regain the full stability and function of your shoulder. Your physical therapist will guide you through a structured rehabilitation program, which typically includes:
- Protecting the Repair: Initially, your arm will be immobilized in a sling to protect the newly repaired labrum and allow it to heal firmly.
- Gradual Movement Restoration: As healing progresses, you’ll begin very gentle, controlled exercises to slowly regain the range of motion in your shoulder and arm, being careful not to stress the repair.
- Progressive Strengthening: Your therapist will introduce strengthening exercises for your rotator cuff, shoulder blade muscles, and surrounding arm muscles. This is vital for providing dynamic support and overall shoulder stability.
- Proprioception Training: Exercises to help your brain and shoulder muscles better understand where your arm is in space, which is key for preventing re-injury.
- Functional Return: As you progress, your therapist will help you gradually return to your daily activities, work tasks, and sports, with careful attention to proper mechanics to protect the newly stabilized joint.
Recovery from a labral repair is a significant process that requires patience and dedication, often taking several months for a full return to demanding activities, especially overhead or contact sports. Following your physical therapist’s instructions closely is crucial for achieving the best possible outcome and preventing future shoulder dislocations.