The shoulder joint is made up of numerous bones, muscles, ligaments, and other tissues. All of these must work together in good rhythm for the shoulder to function correctly. Even a well functioning shoulder can develop problems if not cared for properly or if overused. Also there is always the risk for injury. A relatively common injury to the shoulder is a Bankart lesion. To better understand this condition, a working knowledge of the anatomy involved, the cause and potential problems associated with a Bankart lesion, and the surgery and rehabilitation process is helpful.
The shoulder joint is actually a combination of many joints working together, but for now we will only discuss the glenohumeral joint, the main joint that most would consider the shoulder joint. The glenohumeral joint is where the upper bone of the arm, the humerus, attaches to the body at the scapula. The specific area of the scapula where the humerus attaches is the socket called the glenoid fossa. Running along the rim of the glenoid fossa is a band of cartilage called the labrum. The role of the labrum is to deepen the socket to allow greater congruency between the humerus and the glenoid fossa during movements of the arm.
A Bankart lesion is when the anterior/inferior portion of the labrum is torn away from the glenoid fossa. This is usually caused by a dislocation of the glenohumeral joint anteriorly, or forward. The main problem that can result from a Bankart lesion is recurrent anterior shoulder dislocations. If the shoulder continues to repetitively dislocate it can potentially cause further damage to different areas of the shoulder. For those individuals that continue to experience dislocations surgery is often a good decision.
The surgical technique used to correct a Bankart lesion is simply called a Bankart lesion repair. The goal of the bankart surgery is to reconnect the torn labrum to the glenoid fossa, thus repairing and stabilizing the joint to prevent further dislocations. It is not within the scope of this paper to discuss the different surgical techniques.
The rehabilitation process following a Bankart lesion repair begins almost immediately. Within the first few days following bankart surgery passive range of motion of the shoulder is begun. The patient should be properly instructed by their physical therapist and doctor as to what motions and activities are appropriate to do for regaining range of motion of the shoulder, as some motions are contraindicated.
For the first four-to-six weeks following surgery the focus of the rehabilitation will be on regaining as much range of motion as possible, while continuing to protect surgical repair. During that time the strength of the shoulder will also improve and the symptoms of pain should decrease. At the four-to-six week timeline, depending on the progress, the focus of the rehabilitation will begin to focus more on increasing the strength of the shoulder. As the strength of the shoulder improves, the functional level of the patient will also improve.
By continuing with the proper strengthening program the patient should expect to return to their full level of activity as before the injury without the risk of dislocation.
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