Fractures of the anteroinferior glenoid rim, termed bony bankart lesions, have been reported to occur in up to 22 % of first time anterior shoulder dislocations. Studies have shown that traumatic shoulder dislocations result in recurrent instability. A variation of the bankart lesion, the perthes lesion occurs when the scapular periosteum remains intact but is stripped medially 1, 2, and the anterior labrum is avulsed from the glenoid but remains partially attached to the scapula by the intact periosteum. An osseous bankart lesion is commonly seen in patients with an anterior. Media in category bankart lesion the following 5 files are in this category, out of 5 total. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. A bankart lesion 1 is a lesion of the anterior part of the glenoid labrum of the shoulder. Chen, md, san francisco, ca presents a case of an acute glenoid fracture where he was able to restore the anatomy arthroscopically using the glenoid bone loss set and its 3. Arthroscopic bankart repair for the management of anterior shoulder. Our goal was to analyze the results of 194 consecutive arthroscopic bankart repairs performed by 2 surgeons with. The precise quantification of the bony defect is crucial for the therapeutic. This analogy is used because the articular surface of the round humeral head upper most part of the arm is approximately four times. It is an indication for surgery and often accompanied by a hillsachs lesion, damage to the posterior humeral head.
Pdf background literature on outcomes of arthroscopic bankart repair at the. The lesion itself is usually identified as a compromise or tear of the attachment site of the labrum to the glenohumeral ligaments. A hillsachs lesion is the corresponding lesion or impaction fracture that usually occurs in the posterolateral aspect of the humeral head as the soft cancellous bone of the humeral head rests on the hard cortical glenoid bone during a traumatic glenohumeral dislocation. It has been documented that early management of the associated injury affords better recovery of shoulder function. Rehabilitation guidelines for anterior shoulder reconstruction with open bankart repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee figure 1.
Assessment of coincidence and defect sizes in bankart and. General information there may be a loss of external rotation when compared to the other side, but the motion is. The aim of this study was to investigate bankart and hillsachs lesions with mri to determine the correlation in occurrence and defect sizes of these lesions. The following is a guideline for progression of postoperative treatment.
We use multiple bioabsorbable anchors according to the extent of the lesion for capsularlabral repair. Radiological studies are crucial not only for detecting glenoid bone defects but also for measuring the amount of bone loss. Pdf arthroscopic bankart repair following traumatic recurrent. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation. Figure 2d a type iv slap lesion is a superior labral buckethandle tear that extends into the biceps tendon. Arthroscopic bankart repair with suture anchors tips for. Evaluation of a treatment algorithm for acute traumatic osseous bankart lesions resulting from first time dislocation of the shoulder with a two year followup. The dislocation of the shoulder joint anterior can damage the connective tissue ring around the glenoid labrum. A bankart lesion is an injury of the anterior inferior glenoid labrum of the shoulder due to. Traumatic glenohumeral bone defects and their relationship.
Additional lesions such as a bankart, slap tear, or biceps injury may also be present. Prevalence of associated injuries after anterior shoulder. Here we will look at the common causes, associated injuries, symptoms and treatment options, both surgical and non surgical, for a bankart lesion. A bankart lesion1 is a lesion of the anterior part of the glenoid labrum of the shoulder. On mr a hillsachs defect is seen at or above the level of the coracoid. Injury to these reinforcing soft tissue structures is thought to predispose to recurrent dislocation 7 the term bony bankart contrasted with a soft bankart or fibrous bankart is often used to refer to fracture of the. Arthroscopic stabilization with hillsachs remplissage and. We present a case of recurrent posterior instability associated with a combined phagl injury and posterior osseous bankart lesion. Anterior shoulder dislocation can be associated with many lesions such as bankart lesions, rotator cuff tears rct, hillsachs lesions or greater tuberosity fractures. Of the pooled data, patients who underwent arthroscopic repair of combined bankart slap lesions in treatment of anterior shoulder instability showed a low recurrence rate, favorable functional scores, and no significant restriction on rom, all of which were not significantly worse than outcomes of isolated bankart repair. A typical feature seen in reformatted en face images of the glenoid. Although the labrum may be normally positioned, functionally it no longer provides any stability to the humeral head, mainly as a. Thus, the definition of a bankart lesion is an injury that occurs when the capsularlabral complex is torn from the glenoid rim fig. O retensionamento capsuloligamentar foi realizado quando o.
When the damage only involves the labrum it is called a bankart lesion. Traumatic glenohumeral bone defects and their relationship to failure of. Bankart repair rehabilitation protocol arthroscopicopen. To our knowledge, there has been no reported case of the specific combination of a posterior osseous bankart lesion and a phagl injury. Arthrex arthroscopic management of a bony bankart lesion. Petterson, phd anterior instability treated by arthroscopic surgery is. Achieving the criteria of each phase should be emphasized more than the approximate duration. Multiple cases of this lesion have been reported in the literature711.
When the anterior and inferior ligaments and labrum are. The mri technique is sensitive in diagnosing both injuries. Effects of rehabilitation in bankart lesion in non. Patients with additional surgery will progress at different rates.
Traumatic glenohumeral bone defects and their relationship to. A bankart lesion typically results from a traumatic anterior dislocation of the shoulder. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. The incidence of hillsachs lesion is not known with certainty.
Strictly speaking, a bankart lesion refers to an injury of the labrum and associated glenohumeral capsuleligaments see history and etymology below. Bankart lesions are named after english orthopedic surgeon arthur sydney blundell bankart, 18791951, who first described the injury and the surgical repair process. Perthes lesion is variant of bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped. Pdf arthroscopic bankart repair for the management of anterior. Figure 2b with a typeii slap lesion, the biceps attachment and the adjacent superior aspect of the labrum have pulled off the superior glenoid tubercle. Ulrich j a spiegl, 1, 2 christian ryf, 1 pierre hepp, 2 and paavo rillmann 1. Arthroscopic bankart repair for the management of anterior. A bankart lesion is an injury to the labrum caused by shoulder dislocation 4. Bankart repair protocol vanderbilt university medical center. Outcomes for arthroscopic repair of combined bankartslap.
The bankart procedure is performed to increase anterior stability of the shoulder. Evaluation of a treatment algorithm for acute traumatic. The aim of this study was to highlight the incidence of associated injuries after anterior shoulder. An animated description of two conditions that can occur with a shoulder dislocation and contribute to further shoulder instability. Bankart and hillsachs lesions are often associated with anterior shoulder dislocation. Bankart repair rehabilitation protocol arthroscopicopen this protocol was developed for patients who have had a bankart repair.
Figure 2c a typeiii slap lesion is a superior labral buckethandle tear. Arthroscopic bankart repair is commonly utilized for shoulder stabilization in. Perthes lesion of the shoulder is one of the types of the anterior glenohumeral injury in which the anterior inferior labrum is torn and lifted from the edge of the glenoid 1 but still attached to the intact lifted periosteum from the anterior aspect of the glenoid. It is defined as a detachment of the anteroinferior labrum associated with a glenoid rim fracture. An osseous bankart lesion is commonly seen in patients with an anterior shoulder dislocation. Effects of rehabilitation in bankart lesion in nonathletes. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously puppy party.
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