Overview
Most anterior shoulder dislocations tear the front of the labrum off the glenoid rim — a Bankart lesion — and leave the shoulder without its primary anterior restraint. Without repair, the shoulder often re-dislocates, especially in young athletes; each dislocation adds bone and cartilage damage.
How the Procedure Works
Through arthroscopic portals we mobilize the torn labrum off the glenoid neck — it needs to be freed completely to seat back at the rim rather than healing in a medialized, scarred-down position, which is the most common reason soft-tissue Bankart repairs fail. The anterior glenoid rim is prepared to bleeding bone. We place suture anchors at the glenoid face, typically three, starting at the 5:30 o'clock position and working superiorly — anchor position drives labral height and capsular tension. Each pass brings the labrum back to the rim and tightens the anterior capsule to eliminate the redundancy that allows the humeral head to slip forward. Before closing, we rotate the arm into abduction and external rotation to confirm that instability is eliminated without over-constraining motion.
When to Consider Bankart Repair
Bankart repair is generally offered when symptoms, imaging, and a trial of non-operative care together point to surgery as the next step. The typical picture includes:
First-time or recurrent dislocation
A young active patient, particularly in contact or overhead sport, with one or more episodes of anterior dislocation.
High-risk population
Contact athletes and active military members where recurrence risk without surgery is very high.
Minimal glenoid bone loss
Bone loss on the glenoid rim below the threshold that would mandate a bony procedure like a Latarjet.
Conditions This Treats
Physicians Who Perform Bankart Repair
Providers Who Surgically Assist with Bankart Repair
Risks & Why We Still Recommend It
Every operation carries risk. The reason we offer this procedure is that the condition, left untreated, causes recurrent anterior dislocations — each one damages the labrum, glenoid bone, and cartilage a little more and makes future repair harder. That is the trade we are managing — not eliminating risk, but choosing the smaller of two unfavorable trajectories.
The risks we discuss with patients before bankart repair include:
- bleeding and infection
- anesthesia risk
- stiffness, particularly loss of external rotation
- recurrent instability, especially in contact athletes or with significant glenoid bone loss
- suture-anchor irritation
- transient nerve irritation from positioning or the block
The indication to proceed is recurrent anterior shoulder instability with a Bankart lesion and acceptable glenoid bone stock. Patients who don't need this operation don't get it.
Further Reading
External patient-education references and related OSI pages for additional background: