Among all the joints we have in our body, the shoulder joint is the most frequently dislocated joint following severe trauma. The majority of dislocation occurs in the anterior shoulder, and very few, around 1-3% involve the posterior part of the shoulder. First-time dislocations are frequently caused by falls and auto accidents, but seemingly inoffensive actions like raising an arm above the head or combing hair are frequently the cause of recurring dislocations and can be very troubling.
What is Bankart Lession?
An injury to the shoulder that develops after a dislocated shoulder is called a Bankart lesion. It is an injury to the shoulder’s anterior glenoid labrum. The humeral head might dislocate into a pocket that arises at the front of the glenoid as a result of this. It is a surgical indication and frequently coexists with a Hill-Sachs lesion or posterior humeral head injury. An anterior-inferior glenoid cavity fracture of the scapula bone is a component of a bony Bankart, which is a type of Bankart lesion.
There are two kinds of Bankart lesions:
- Soft Bankart lesion: only the soft tissue is injured, and the labrum tears off the glenoid.
- Bony Bankart lesion: There are tears in the labrum and a partial fracture or breakage of the bony glenoid and could lead to a substantial loss of glenoid bone, which might create instability over time.
Patients experiencing anterior dislocation frequently have a Bankart lesion. In the event of a posterior dislocation, a reverse Bankart lesion may develop.
Why Do We Perform Bankart Repair Surgery?
Males experience shoulder dislocations more frequently than females do, as do teenagers. When the shoulder is dislocated once due to an accident or any other reason, it tends to be dislocated frequently as the joints are not as stable as before even after treatment. This is mainly because the fibrocartilage labrum at the anterior shoulder becomes torn. The condition affects the person’s quality of life, limiting their ability to perform effectively. Bankart repair surgery helps to return people to their normal state of ability to perform sports and work activities.
Types and Procedures of Bankart Shoulder Repair
There are two approaches to Bankart shoulder repair surgery, an open type and an arthroscopic type.
Open Bankart repair:
A large incision is made at the anterior portion of the shoulder to get access to the joint. The damaged labrum and ligaments are repaired and repositioned through the incision. It is mostly preferred for an individual whose labrum is fully separated following a forceful dislocation. The repair aids in stabilizing the ball as it re-enters the shoulder joint’s socket.
Arthroscopic Bankart Repair:
The process is mostly performed using bone anchors that are drilled into the glenoid, the socket portion of the shoulder joint. The bone anchors have sutures attached to it which will tie the torn labrum back to the anterior glenoid from where it has been torn. Simultaneously, capsulolabral plication would be performed. The stretched shoulder joint capsule due to dislocation is sutured into the anchors to further tighten the shoulder.
Both the operations are conducted under general anesthesia and it usually takes more than an hour. The patients normally will have to stay overnight at the hospital and be discharged the next day. The stitches of the incision would remain as such for 10-14 days. Patients are usually prescribed pain medications and antibiotics to alleviate the post-surgical pain and to prevent an infection.
Bankart Repair Cost in India
Bankart Repair Cost in India starts from INR 60,000 (700 USD). The price of bankart repair typically varies depending on a number of criteria across different hospitals and locations. The kind and condition of your bankart shoulder joint, the recommended course of therapy, the cost of follow-up consultation fees, medications, and post-procedure care are some of the elements may affect the price of bankart repair cost in India. The exact course of treatment needed for each patient determines the total cost of care.
Diagnosis and Treatment Procedure for Bankart Repair
Similar to all other orthopedic tests even for a Bankart repair your orthopedic surgeon will suggest you have some test before the treatment. The following are the types of diagnosis done:
- Physical examination
- X-ray
- CT scan
- MRI scan
Procedure of the Surgery
- General anesthesia is used to put the patient to sleep before surgery, while regional anesthesia is used to numb the entire arm.
- Three tiny incisions are made by the surgeon around the shoulder region during the surgery. An arthroscope is a thin tube that is put into the shoulder and has a camera and light attached. The images are displayed on a TV screen in real-time.
- After examining the ripped ligament, the physician determines which parts need to be fixed.
- To insert the device for securing the bone anchors and suturing the ripped labrum segments to the glenoid, another incision is created.
- The final stage involves using stitches and sutures to hold the labrum in place and using tiny anchors to keep the tissues attached to the bone.
After Surgery
- The patient’s vital signs will be regularly monitored by nurses.
- To limit movement, an immobilizing sling is fastened around the operated arm.
- A physical therapist will counsel patients on activities that will help them restore the full range of motion in their shoulders.
- Painkillers are recommended by doctors and most people are able to go home the next day.
- For four weeks, the immobilising sling must be worn continuously, only to be taken off for baths.
- During this time, exercises for strengthening the muscles with restricted motion are performed.
- After two days, patients can take off the dressing and cover the surgical site with an adhesive bandage.
- After a 12-week period, the majority of patients regain full mobility.
- For the majority of patients, at-home physical treatment is sufficient.
Advantages of Arthroscopic Bankart Repair Over Open Surgery
Both types of surgery have a high success rate and do not have a significant outcome. However, arthroscopic method might be preferred over open surgery due to the following reasons:
- Better visualization of shoulder anatomy during the surgery
- Less chances of complication
- Faster postoperative recovery
- Less pain and discomfort
- Lower risk of redislocation
Risks Associated With Bankart Repair
Common risks associated with the surgery that have to be kept in mind are as follows:
- Nerve injury or damage during the surgery
- Infection of the wound / surgical site
- Stiffness of shoulder
- Recurrence of instability
- Failure of the surgery resulting in shoulder weakness
Medication might help alleviate the pain ad discomfort of shoulder dislocation but it is not able to heal the torn labrum. Exercise is the first choice of treatment and in some instances, it can restore the stability of the joint but does not specifically treat the cause of the instability. So having a repair surgery is the most effective way to treat the condition. The surgical approach has to be tailored depending on the specific circumstances.
Why Choose Dr. N. K. Magu?
Dr. N. K. Magu is a world-renowned orthopedic surgeon from India whose outstanding expertise and dedication to the field have gained him international fame. Over the course of several decades, Dr. N. K. Magu has proven to be an exceptional specialist in a number of orthopedic fields, especially when it comes to hip preservation, reconstruction, proximal femoral osteotomies, and other related areas. His reputation as one of the best orthopedic surgeons in the world has been cemented by his unparalleled commitment to enhancing the quality of life for his many patients.
