Type of Surgery
Last updated: 02/17/2009
The physician diagnoses a Bankart lesion from the patient's history, by performing a thorough physical examination of the joint, and taking the proper x rays. The examination often reveals that the head of the humerus slips easily out of the...
joint socket, even when it is pressed into it. This is called the "load and shift test." X rays may also reveal that the bony lip of the glenoid socket is rounded or deficient, or that the head of the humerus is not centered in the glenoid cavity.
A diagnostic arthroscopy is also often used to confirm the presence and extent of the shoulder instability. In this procedure, a thin fiberoptic scope is inserted into the shoulder joint space to allow direct visualization of its internal structures. An electromyogram may also be obtained if the treating physician suspects the possibility of nerve injury.
Patients should attend to any health problem so as to be in the best possible condition for this procedure. Smoking should be stopped a month before surgery and not resumed for at least three months afterwards. Any heart, lung, kidney, bladder, tooth, or gum problems should be managed before surgery. The orthopedic surgeon needs to be informed of all health issues, including allergies and the non-prescription and prescription medications being used by the patient.
A Bankart procedure, also known as a Broca-Perthes-Bankart procedure, is a surgical technique for the repair of recurrent shoulder joint dislocations. In the procedure, the torn ligaments are re-attached to the proper place in the shoulder joint, with the goal of restoring normal function.
The shoulder is the junction of three bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). The shoulder joint (glenohumeral joint) is the result of the head of the humerus bone fitting in the cavity of the shoulder blade (glenoid cavity), the joint being held together by the labrum, a rim of soft tissue that surrounds the glenoid. As a result of excessive force being applied to the arm, the head of the humerus may be forced out of the glenoid cavity (dislocation), and the supporting ligaments of the shoulder joint may be torn. These ligaments may heal so that the shoulder regains its stability. However, sometimes the ligaments do not heal, making the shoulder unstable and painful. This condition is referred to as traumatic instability of the shoulder, traumatic glenohumeral instability, or a Bankart lesion.
The goal of a Bankart procedure for traumatic glenohumeral instability is the safe and secure re-attachment of the torn ligaments to the tip of the glenoid from which they were detached. The surgery has the advantage of allowing patients to resume many of their activities of daily living while the repair is healing. The surgery also minimizes the unwanted joint stiffness associated with such injuries.
New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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