This document describes the arthroscopic Bankart repair procedure for a 26-year-old male patient with recurrent right shoulder instability. An MRI showed a Bankart lesion and Hill-Sachs lesion. During the arthroscopic procedure, the Bankart lesion extending from the 2 to 5 o'clock position on the glenoid was repaired. Post-operatively, the patient's arm was immobilized for 3 weeks followed by a rehabilitation program. Arthroscopic stabilization allows for a complete inspection of the joint and treatment of all intra-articular lesions while preserving range of motion.

1. Arthroscopic Bankart’s repair

2. History
 26 yrs old male , Right handed individual , computer
programmer by profession , recreational sportsman ,
presented with Recurrent episodes of instability of
Right shoulder for 6yrs.
 Episodes 10/year. Last episode 1 week back.
Treated with CR.

3. History
 Tenderness anterior aspect . Wasting of Deltoid ,
Positive Hamilton ruler test. All ROM restricted and
painfull . Apprehension present . No evidence of
multidirection, sulcus sign present.
 MRI done– Bankart’s lesion. Posteromedial
Hillsach’s lesion.

4. MRArthrogram
 Bankart’s lesion
 Postero-medial
Hillsach’s lesion

5. What is Bankart’s ?
 Capsulo-labral
avulsion of the
Anterior capsule
from the Glenoid.

6. Procedure

7. Examination underAnaesthesia
 Anterior drawer’s grade 2+.
 Sulcus sign grade 2.

8. Arthroscopic Bankart’s repair
Bankart’s
lesion extending
from 2 to 5 ‘O’
clock position.
Inferior capsule
lax.
Glenoid

9. Post-operative Radiogram
 Immobilisation in
arm sling for 3
wks. Passive and
active assisted at
3 wks. Abduction
only to 90. No ER.
At 6 wks full Rom
and rotator
strengthening.

10.  Advantages of Ascopic stabilisation.
 Smaller skin incisions.
 Complete inspection of joint.
 Ability to treat all intraarticular lesions.
 Ability to access all areas of GH joint.
 Less soft tissue dissection.
 Preservation of ER.

11.  T.Neviaser identified ALPSA(anterior
labroligamentous periosteal sleeve
avulsion) in anterior-inferior GH instability.
 High failure rates in previous ascopic
repairs due to technical factors- medial
repair of anterior labrum.
failure to treat ALPSA, SLAP, rotator
interval, capsular tensioning.

12.  Neer’s concepts
 GH instability in multiple directions
 Correction of all 3 symptomatic directions
is necessary.
 Scoring systems used- American shoulder
and elbow surgeons shoulder index ,
constant scoring systems.

13.  Indications- persistant shoulder pain from
GH instability that has not responded to 6
mnths of non-opretive treatment.
 Factors to be considered; age, severity of
initial trauma, reduction method, arm
dominance, activity level, sports , desired
level of activity, instability, radiographic
finding’s.

14.  Contraindications- who demonstrate GH
instability , voluntary muscular contractions ,
emotional instability, Glenoid defects more
thyan 4 mm.
 Hill-S-sach’s lesion engaging the anterior
Glenoid.