Bankart Repair Surgery

Surgical Repair of the Labrum in People With a Shoulder Dislocation

Shoulder dislocation surgery is called a Bankart repair. Science Photo Library / Getty Images

A shoulder dislocation occurs when the ball of the shoulder joint comes out of the socket. When the ball comes completely out of the socket, almost always some stabilizing structure is injured. In older patients, the rotator cuff may be torn, but in younger patients (under the age of 35), it is almost always the labrum that is torn when the shoulder dislocates.

The specific type of labral tear that occurs is called a Bankart tear, and it signifies the location of the problem.

The Bankart tear occurs in the anteroinferior part of the shoulder joint – in the front and lower portion of the socket. Because the ligaments of the front of the shoulder helps maintain the joint in proper position, a Bankart tear (a tear of the inferior glenohumeral ligament), will make the shoulder prone to repeat dislocation.

Chance of Repeat Dislocation

The chance of the shoulder dislocating after a Bankart tear depends most significantly on the age of the patient. Younger patients are most likely to sustain a Bankart tear if their shoulder dislocates, and are therefore more likely to have a repeat shoulder dislocation. Statistically, the chances of a second dislocation in the shoulder are greater than 80 percent in patients younger than 30 years of age. Over 30 years old, the chance of a repeat dislocation drops significantly.

Because of the high risk of repeat dislocation, many surgeons recommend surgery to repair the Bankart tear, even after a patient's first dislocation.

Traditionally, surgery was only performed after patients had at least two dislocations; the thought being that a patient had to "prove" their shoulder required stabilization surgery. Many surgeons now believe, especially in patients under 22 years of age, the risk of repeat dislocation is so high that surgery should be performed after an initial dislocation.

Bankart Tear Surgery

Surgery to repair a Bankart tear can be performed as an arthroscopic surgery or as a more traditional open surgery. The procedure is performed to reattach the damaged labrum to the rim of the shoulder socket (the glenoid).

Typically, the rim of the shoulder socket is abraded with a rasp to stimulate a bleeding response (helps to allow healing). At that point, your surgeon will place suture anchors into the bone. The anchors have sutures attached and can be firmly seated within the bone. The sutures attached to the anchor are passed through the labrum, and sometimes the capsule of the shoulder as well) and tightly tied to reattach the damaged tissue.

As mentioned, the surgery can be performed arthroscopically or as an open surgical procedure. The results of both techniques are very good in terms of preventing the chance of another dislocation. The advantage of arthroscopic surgery is there is less discomfort with this minimally invasive technique, and the surgeon has the ability to see around the entire shoulder to better assess the cartilage, rotator cuff, and other structures.

Typical post-operative recovery involves a period of immobilization. Most surgeons begin early mobility to prevent patients from developing a stiff shoulder.

There is some limitation of activity for a minimum of 3 months, and most athletes don't return to full sports activities until about 6 months from the time of surgery.

Should You Have Surgery?

There is no right answer to this question, and every patient needs to consider their individual situation. It is true that young athletes, especially those who participate in contact sports (e.g. football, hockey), who dislocate their shoulder will have a very high chance of a repeat dislocation without surgery. In addition, the progression to developing post-traumatic arthritis of the shoulder is directly related to the number of dislocations of the joint.

Patients should discuss with their orthopedic surgeon the likelihood of repeat dislocation given their age, activity level, and injury, and from this to determine if surgery is appropriate. Patients considering surgery must also understand that returning to unrestricted sports activities will be about 4-6 months, and even surgery does not guarantee that further dislocations will not occur.


Kirkley A, et al. "Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation." Arthroscopy. 2005 Jan;21(1):55-63.

Lintner SA and Speer KP "Traumatic Anterior Glenohumeral Instability: The Role of Arthroscopy" J Am Acad Orthop Surg October 1997 ; 5:233-239.

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