Chapter-05 Arthroscopic Bankart Repair

The anterior capsulolabral complex is composed of the labrum, capsule, and the anterior inferior glenohumeral ligament. Function of the complex is to increase the depth of the glenoid cavity to stabilize the glenohumeral joint. Furthermore, this soft tissue complex will resist anterior translation of the humeral head when the shoulder is placed in 90° of abduction. Anterior shoulder dislocation is the most common pattern of instability and 85% is associated with a Bankart lesion.Open Bankart repair has been the standard of treatment and is associated with good functional outcome with low recurrence rate. In 1987, Morgan et al reported on the result of arthroscopic Bankart repair in 25 patients with transglenoid suture fixation. There was no recurrent instability and all patients were rated excellent with pain free full range of motion. With the advancement of arthroscopic instrumentation and techniques, subsequent studies comparing arthroscopic versus open Bankart repairs have demonstrated equal functional outcomes and no differences in the recurrent dislocation rates. The advantages of arthroscopic anterior shoulder stabilization is the ability to provide clear images of the anatomy and pathology of the shoulder joint in a minimum invasive setting without violating the subscapularis muscle. This technique will also allow the surgeon to manage concomitant lesions such as posterior or superior labral tears, rotator cuff tears, and any other pathology. Other advantages of arthroscopic technique when compared to the open procedure are less postoperative pain, greater range of motion, faster recovery and better cosmesis.