Shoulder instability with a Bankart Tear

What is a Bankart tear of the shoulder?

The Bankart lesion is a specific injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable.

To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. This cuff of cartilage makes the shoulder joint much more stable, yet allows for a very wide range of movements

What is a Bankart lesion?

When the labrum of the shoulder joint is torn, the stability of the shoulder joint is compromised.

A specific type of labral tear is called a Bankart lesion. A Bankart lesion occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients.

How is the diagnosis of a Bankart lesion made?

Most young patients (under the age of 30) who sustain a shoulder dislocation will sustain a Bankart lesion; therefore, there is a high suspicion of this injury whenever a patient dislocates their shoulder. On examination, patients will often have a sense their shoulder is about to dislocate if their arm is placed behind their head.

X-rays are sometimes normal, but they may show an injury to the bone called a Hill-Sachs lesion. This is a divot of bone that was injured when the shoulder dislocation occurred. A MRI may also be obtained in patients who are suspected of having a Bankart lesion

What is the treatment for a Bankart lesion?

There are two general options for the treatment of a Bankart lesion. One option is to allow the arm to rest, and the inflammation to subside with the use of a sling. This is usually followed by physical therapy to regain motion of the extremity.

The other option is to perform surgery to repair the torn labrum. When surgery is performed, the torn labrum of the Bankart lesion is reattached to the socket of the shoulder. The results of surgery are usually very good, with a large percentage of patients returning to their activities without any further dislocations.

What are the chances of a repeat dislocation after a Bankart injury?

It is important to realize that the chance of the shoulder dislocating after a Bankart injury depends on the age of the patient. Younger patients are most likely to sustain a Bankart injury if their shoulder dislocates, and are therefore more likely to have a repeat, or recurrent, dislocation.

A bankart repair for a torn labrum with shoulder instability

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