A shoulder that repeatedly slips out of place can cause pain, weakness and a feeling that the shoulder may dislocate again during everyday activities or sports.

When the shoulder dislocates, the strong tissue that helps keep the ball of the shoulder joint in its socket can become torn away from the edge of the socket. This injury is commonly called a Bankart tear.

Arthroscopic Bankart repair is a keyhole operation that repairs this torn tissue and restores stability to the shoulder.

When is arthroscopic Bankart repair needed?

Not everyone who dislocates their shoulder needs surgery.

Surgery may be considered when:

• The shoulder has dislocated repeatedly

• The shoulder feels unstable or as though it may slip out again

• The first dislocation occurred during sports or another demanding activity

• Shoulder instability is interfering with work, exercise or daily activities

• The torn tissue is suitable for repair

• There is no major loss of bone from the shoulder socket

The decision depends on the patient's age, activity level, number of dislocations, condition of the shoulder and the amount of damage seen on scans.

In some patients, particularly those with significant loss of bone from the shoulder socket or other important changes, Bankart repair alone may not be sufficient and another type of stabilizing operation (Latarjet procedure or Remplissage) may be more appropriate.

What is a Bankart tear?

The shoulder is a ball-and-socket joint. The ball at the top of the arm normally sits inside a shallow socket.

A soft rim of strong tissue surrounds the socket and helps keep the ball in place.

When the shoulder dislocates, this tissue can be torn away from the edge of the socket. This tear is called a Bankart tear.

The torn tissue may not return to its normal position or heal adequately on its own, particularly when the shoulder continues to dislocate.

What is arthroscopic Bankart repair?

Arthroscopic Bankart repair is a keyhole operation to reattach the torn tissue to the edge of the shoulder socket.

A small camera and special instruments are introduced through small cuts around the shoulder.

The torn tissue is brought back to its normal position and held securely with strong stitches and small devices placed in the bone.

As healing takes place, the repaired tissue becomes firmly attached to the edge of the socket again.

The aim is to restore the natural support of the shoulder and prevent the ball from repeatedly slipping out.

What happens during the operation?

The operation is performed through small cuts around the shoulder.

The surgeon first examines the shoulder and identifies the torn tissue and any other damage.

The edge of the socket is prepared carefully. The torn tissue is then brought back to its normal position and secured with strong stitches attached to small devices placed in the bone.

The shoulder is checked at the end of the operation to ensure that it has good stability and movement.

If another problem is found that needs treatment, it may sometimes be treated during the same operation.

What are the benefits?

When appropriately selected, arthroscopic Bankart repair can:

• Improve shoulder stability

• Reduce the chance of repeated dislocation

• Reduce the feeling that the shoulder may slip out

• Improve confidence during daily activities

• Improve shoulder function

• Help patients return to exercise and sports

• Reduce the risk of further damage caused by repeated dislocations

The goal is to restore a stable, functional shoulder, rather than simply treating the tear seen on a scan.

Is Bankart repair suitable for every dislocating shoulder?

No.

Bankart repair works best when the main problem is a torn soft tissue rim around the socket and there is no significant loss of bone.

If a substantial amount of bone has been lost from the socket, or if there are other important changes in the shoulder, repairing the torn tissue alone may have a higher chance of failure.

In such cases, another stabilizing procedure may be recommended (like Latarjet procedure and Remplissage).

This is why careful assessment of the shoulder and appropriate scans are important before deciding on the operation.

What is recovery like?

The repaired tissue needs time to heal securely, so the shoulder is protected during the early part of recovery.

A sling is usually worn initially. Gentle movement is then introduced gradually, followed by exercises to restore movement and strength.

Recovery generally includes:

• Protecting the shoulder during the early healing period

• Controlling pain and swelling

• Gradually restoring shoulder movement

• Strengthening the shoulder muscles

• Improving shoulder control

• Gradually returning to normal activities

• Later returning to sports

Regular physiotherapy and following the recommended exercise programme are important for protecting the repair and achieving a good result.

When can I return to work?

This depends on the type of work you do.

People with desk-based work may return earlier, while jobs involving heavy lifting, pushing, pulling or repeated overhead activity require more time.

Your return to work should be gradual and based on the healing of the repaired tissue and the physical demands of your job.

When can I return to sports?

Return to sports takes longer than returning to everyday activities.

The shoulder needs to regain adequate movement, strength and stability before demanding activities are resumed.

Sports involving throwing, contact, overhead activity or a high risk of falling require particular care.

Many appropriately selected patients can return to sports after successful healing and rehabilitation, although the timing depends on the sport and the individual recovery.

What are the risks?

Arthroscopic Bankart repair is a commonly performed procedure, and serious complications are uncommon.

Possible problems include:

• Infection

• Bleeding

• Shoulder stiffness

• Continued pain

• Continued feeling of instability

• Another shoulder dislocation

• The repaired tissue not healing adequately

• The shoulder becoming unstable again over time

• The need for another operation

The chance of the shoulder becoming unstable again depends on factors such as age, type of sport, the amount of previous damage and whether there is bone loss.

Following your surgeon's advice and keeping up with physiotherapy can help support recovery and protect the repair while it heals.

Frequently Asked Questions

Does every shoulder dislocation need surgery?

No. Some patients recover well with non-surgical treatment. Surgery is considered when the shoulder repeatedly dislocates, remains unstable or is likely to benefit from surgical stabilisation.

Will Bankart repair stop my shoulder from dislocating again?

The aim of the operation is to restore shoulder stability, improve shoulder function and reduce the risk of recurrent dislocation. Most appropriately selected patients experience significant and lasting improvement in stability and function following surgery.

How long does recovery take?

Recovery takes several months. The repaired tissue needs time to heal before the shoulder can safely be exposed to heavy lifting, throwing or contact sports.

Can I return to sports after Bankart repair?

Many patients can return to sports after successful healing and rehabilitation. The return should be gradual, and contact or high-risk sports are introduced only after adequate strength and stability have returned.

Why can't every shoulder dislocation be treated with Bankart repair?

Bankart repair is most suitable when the main problem is a tear of the soft tissue around the socket. If there is significant loss of bone or other major changes in the shoulder, another procedure may provide better stability.