Symptoms and recovery steps of bankart repair?

Bankart Repair surgically treats torn ligament tissue in the lower, front part of the shoulder. Shoulder dislocation often causes a Bankart lesion or tearing of the inferior glenohumeral ligament part of the labrum. The labrum is a ring of fibrous cartilage that lines the bone socket of the shoulder, known as the glenoid. The labrum deepens the socket and adds stability to the shoulder. A Bankart lesion significantly weakens the shoulder.

Common signs and symptoms include:

  • Weakness in the shoulder when lifting, throwing or reaching overhead
  • Rotational instability
  • Pain in the shoulder with movement, especially overhead motions
  • Aching sensations
  • The shoulder locking up or needing to pop

Purpose of the procedure
The torn ligaments need to be re-attached at their respective places in and around the joint so as normal functionality is restored. The objective of the Bankart procedure for Bankart lesion or the glenohumeral instability is to safely and securely reattach the ruptured ligaments to the glenoid from the part where they got detached. This surgery does not reduce the normal functioning of the arm while it is healing which serves as an advantage to the surgery. It also helps with the joint stiffness which follows such injuries. The joint capsule is attached or sewed back together with the glenoid cavity (the labrum surrounding it), without making a duplicate of the subscapularis tendon (The large triangular muscle in a part of the humerus and the anterior part of the joint).

This shoulder is the most commonly affected joint after a trauma, like a fall, a vehicle accident, etc. The first-time dislocation can occur due to major accidents but the repeated dislocations are caused mostly by visibly undemanding activities like lifting an object, combing hair or even by merely raising one’s arm above the head.

Preparation

At Apollo Spectra, the diagnosis is done through a thorough physical examination and an X-ray. The humerus is pressed into the socket and noted whether it slips back, this is called the “load and shift test”.

The surgery at Apollo Spectra is generally carried out in two ways:
• Arthroscopic surgery (Closed surgical technique)
• Open surgery

Arthroscopic surgery– Most of the patients opt for the closed surgery type because of the fact that only a small incision is made on the skin and the surgery is done with the help of various implants of choice, suture and an endoscope.

Open surgery– The open surgery procedure is done under local or general anaesthesia. The whole upper limb is sterilised with antiseptic. A pre-surgery test is done to determine the exact nature of the instability under anaesthesia. A long cut or incision is then made to get to the concerned joint for further procedures. The health of the patient is a key factor in the surgery and should be maintained. Also, your doctor may ask you to quit smoking one or two months before planned surgery. Allergies and medicines currently being used should be informed to the surgeon before the surgery. In the end, the patient should not eat or even drink anything from the beginning of the operation day (12 a.m. onwards on the day of operation).

Procedure

Arthroscopic Bankart Repair is a relatively new procedure that uses three or four smaller incisions. The arthroscopic procedure takes longer but has a shorter postoperative recovery time. Factors such as age, physical activity, and the extent of damage are taken into account before deciding which procedure is best for each patient. Once the anaesthesia has taken effect, small cuts (about 5mm long) are made in the skin around the shoulder that is being treated. Sterile fluid is injected into the joint to help produce a clearer picture. The arthroscope is inserted through one of these cuts into the joint.

The surgeon will look around the entire joint to check the cartilage, tendons, and ligaments of the shoulder. If damaged tissues need to be repaired, the surgeon will make 1 to 3 additional small incisions to insert other instruments. These may include a blunt hook to pull on tissues, a shaver to remove damaged or unwanted tissues, and a burr to remove bone. The surgeon will attach sutures to dissolvable anchors and securely fix the anchors to the glenoid. The surgeon will then run the sutures through the labrum and securely fasten it to the glenoid, thereby fixing the Bankart lesion.

Results

University of California, Los Angeles (UCLA) evaluated the various aspects of a patient’s recovery status and came up with the conclusion that the pain index, functionality, active forward flex limit and forward flexion strength along with the comfort of the patient all significantly increased after the surgery with only 3 shoulders out of 73 scoring poorly. Of these, 75% of the patients who played contact sports returned to their previous sporting activities, while the remainder refrained from further sports due to the fear of recurrence. The patients who were under study were also asked to rate their overall shoulder stability from 0 to 10 (0 being the most stable). The mean, post-surgery came at 1.89 as compared to before the surgery which was 7.33.

We at Apollo Spectra, strive to deliver the best results.

Risks

There are a few risks associated with the Bankart procedure

• Wound infection and break in the repair
• Nerve (Perioperative) or blood vessel damage during surgery and wrong placement of anchor sutures
• Recurrence of shoulder instability, shoulder weakness resulting from poor healing
• Tear of the rotary cuff

There might be some inflammation which is not a risk or a situation to be worried about. It goes away on its own.

Recovery

The first few days are a little difficult on the shoulder post-surgery which gets better gradually. For the first four weeks, the arm requires a sling. Therapies and rehabilitation sessions are recommended for patients. They are the key to making full recovery.

Our expert team of surgeons are equipped with advanced technology, to ensure that your shoulder function is restored to normal, howsoever complicated its condition is.

We at Apollo Spectra, ensure that our patients are provided with the best care, pre and post their surgery. We make sure that their stay here is comfortable and that they’re given the best possible facilities. Our aim is to take care of your loved ones.

FAQs
• Can medicines help?

They might help with the recovery process or as pain-killers, but medicines cannot be substituted for the surgery.

• How long does the recovery take?

The recovery depends on the patient and the care he takes. The recovery can be sped up by therapy and rehabilitation sessions.

• Which surgery is better, the open or the closed?

After the advancement in medicine, the closed surgery is preferred by people but if there is a loss of ligament or bone structure due to an accident, the open surgery remains the only option.