Bankart repair surgery: Treatment of shoulder instability
The Bankart procedure is one of two operations (along with the Latarjet procedure) used to treat shoulder instability. Performed arthroscopically, this operation results in less painful postoperative recovery and a faster return of shoulder function.
What is a Bankart repair?
Indications for a Bankart repair surgery
A Bankart repair is a surgical procedure indicated to treat shoulder instability. Chronic shoulder instability is defined after 2 to 3 episodes of dislocation or subluxation (partial dislocation with spontaneous reduction).
This condition can also be treated using a Latarjet procedure. The choice of surgical technique will be made during consultation with Dr Roure. He will clearly explain the advantages and disadvantages of each procedure based on your individual situation.
In the case of a single shoulder dislocation, surgery is not always necessary. Initial treatment may consist of immobilisation and physiotherapy.
Principle of the procedure
Shoulder stability refers to the stability of the humeral head in relation to the glenoid of the scapula. This stability is ensured by the joint capsule reinforced by ligaments surrounding the joint, as well as the glenoid labrum (a fibrocartilaginous rim acting like a gasket that stabilises the humeral head).
In case of shoulder dislocation, these ligamentous structures and the labrum are torn, leading to pain, functional limitation, and recurrent dislocations occurring with increasingly minor trauma.
The Bankart procedure is a form of shoulder surgery. It aims to restore stability by reattaching and tightening the torn capsule, ligaments, and labrum.
The procedure is performed using arthroscopy, a minimally invasive technique using a camera and small instruments inserted through two small incisions of a few millimetres. This approach reduces postoperative pain and allows a faster recovery of shoulder function.
Bankart vs Latarjet procedure
The Bankart procedure is one of two main surgical options, alongside the Latarjet procedure, used to treat shoulder instability.
The main advantage of Bankart repair is a faster recovery and minimal scarring. However, it may have a higher recurrence rate compared to bone-block procedures (Latarjet), depending on anatomical lesions and patient profile (hyperlaxity, sports activity level, etc.).
Dr Roure will guide you in choosing the most appropriate procedure for your situation.
Bankart procedure overview
Day of surgery
The Bankart procedure is performed under general anaesthesia.
It is carried out arthroscopically through two small portals (one posterior and one anterior), allowing insertion of the camera and surgical instruments.
The torn capsular and ligamentous structures are repaired and reattached to the glenoid using anchors. These anchors (usually absorbable) are placed in the bone and hold sutures that secure the repaired tissues back to the bone.
Postoperative care
A sling immobilisation is usually prescribed for 5 to 6 weeks.
The arm is not fully immobilised at all times: the hand and elbow can be used immediately. However, abduction and external rotation movements must be avoided. A sling is recommended when outside or during sleep to prevent accidental movements.
From the day after surgery, patients perform self-rehabilitation exercises several times a day, taught by a physiotherapist before discharge.
Dressings are changed every two days by a nurse for the first two weeks.
After sling removal, a structured physiotherapy program is started to optimise functional recovery.
Return to sport
Jogging may resume after 6–8 weeks, as well as swimming (initially breaststroke). Golf can usually be resumed after 2 months (starting with putting).
Gym training and tennis may be gradually resumed after around 3 months, while contact sports are typically resumed after 5 months, once adequate shoulder reconditioning is achieved.
Summary
- Anaesthesia: General
- Hospital stay: Outpatient or 1 night
- Immobilisation: 5–6 weeks in a sling (hand and elbow remain usable)
- Rehabilitation: Immediate self-exercises; physiotherapy starts at 6 weeks
Recurrence and possible complications
Complications after Bankart repair surgery for shoulder instability are rare, but possible and should be discussed before surgery.
Recurrence
Recurrence of shoulder dislocation may occur after Bankart repair. It is not predictable before surgery.
It may occur early or several years later, and may present as subluxation episodes, with pain, instability sensations, and spontaneous reduction.
In case of significant recurrence, revision surgery may be considered. A Latarjet procedure may then be recommended, as it provides a lower recurrence rate. Each technique has specific advantages and limitations that will be discussed with the patient.
Infection and residual stiffness
Infection is rare but possible after Bankart surgery and may require medical or surgical treatment.
Complications such as stiffness or complex regional pain syndrome (CRPS) are uncommon but unpredictable. CRPS may cause prolonged pain and shoulder stiffness, sometimes extending to the arm, with a potentially prolonged recovery period.