Shoulder stabilisation (Bankart repair)
What is a shoulder stabilisation?
The aim of a shoulder stabilisation also known as a Bankart repair operation is to restore stability to the shoulder. The operation is suitable for people who have detached the labrum and ligaments at the front of the shoulder as a result of an original violent dislocation. Usually the shoulder has remained unstable and may have dislocated on a number of further occasions.
After the operation, you should not suffer further dislocations and have much reduced pain.
What does this involve?
Bankart shoulder repair surgery is performed under general anaesthetic and takes around an hour and a half. Usually the nerves to the whole arm are also numbed with local anaesthetic which lasts for sixteen to twenty-four hours. This technique is called a regional block and is similar to the idea of an epidural anaesthetic frequently used in childbirth. This regional block not only means that a lighter general anaesthetic is required, reducing postoperative sickness and nausea, but also provides excellent pain relief afterwards.
The operation is carried out as a conventional open operation through an incision at the front of the shoulder, or telescopically through a number of small incisions around the shoulder. The aim is to restore the labrum and ligaments to their original position on the edge of the socket and they are encouraged to heal there.
The first step in the operation is to mobilise and re-position the labrum and ligaments and to create an environment in which healing can occur. Little harpoons or anchors are then inserted into the bone on the edge of the socket, which gain a good grip. Stitches on these anchors are then used to suture the labrum and ligaments back into place. The anchors and sutures then hold everything in the right place while natural healing occurs.
The incisions are closed with stitches and waterproof dressings are applied.
When will I recover?
The operation requires a one night stay in hospital and your stitches will come out at one to two weeks after the surgery. Your arm is placed into a special shoulder-immobilising sling and exercises and physiotherapy start on the day of surgery. Your physiotherapist will teach you all you need to know for the first couple of weeks before your discharge from hospital.
As a general guideline, your sling will be retained for a period of four weeks during which time you will be quite one-handed. At four weeks, the sling generally goes and increased exercises and movement are encouraged. Most people can return to driving a car at around six weeks and will have regained good ordinary use of the shoulder by eight to ten weeks.
Physiotherapy and exercises continue for four to six months and sports that do not impose too much stress on the shoulder, such as running, can start again at around eight to ten weeks. Activities such as golf and swimming can be resumed at around three months. Contact sports, including rugby and football and other high demand sports such as surfing and climbing can be reintroduced at six months.
In addition to regular treatment with the physiotherapist, follow up is required with your surgeon. This is to monitor and guide progress and to look out for complications which are fortunately all rare.