This rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Dislocation of the shoulder joint occurs in 1 to 2% of the populatio. A bankart lesion is an injury of the anterior inferior glenoid labrum of the shoulder due to. A bankart lesion is an injury to the labrum caused by shoulder dislocation 4. Bankart lesions are named after english orthopedic surgeon arthur sydney blundell bankart, 18791951, who first described the injury and the surgical repair process. Immediately postoperatively, exercises must be modified so as not to place. When the anterior and inferior ligaments and labrum are damaged. Media in category bankart lesion the following 5 files are in this category, out of 5 total. Rotator cuff lesions were the least prevalent type, seen in only one patient 1. The second most frequent type was hillsachs lesions, in 71. The osseous bankart lesion is an avulsion of the humeral labral complex with an anterior rim fracture. Arthroscopic bankart repair is commonly utilized for. It may result either from a traumatic glenohumeral dislocation or a direct trauma to the adducted arm. Involves a bucket handle tear of the superior labrum which extends into.
The incidence of these lesions in the setting of glenohumeral instability is relatively high and approaches 100% in persons with recurrent. The bankart lesion is named after english orthopedic surgeon arthur sydney blundell bankart. This lesion is reported to be as high as 90% after a traumatic shoulder dislocation. We detail a previously unreported case of a hagl lesion occurring in a shoulder with an intact arthrosopic bankart repair following an additional traumatic event. Orthopaedic surgery, sports medicine and rehabilitation bankart repair post operative rehabilitation protocol general considerations. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously with a. Bankart lesion, humeral avulsion of the glenohumeral ligaments hagl lesion, and capsular rupture. Data from 79 shoulders in 74 patients were collected over 4 years 2004 2008.
Use superior flap to double thickness of capsule and eliminate excess capsular laxity. Hagl lesion occurring after successful arthroscopic bankart. Additionally, mri revealed 2 capsular stretch injuries in addition to the bankart and hillsachslesions. The anteriorinferior labrum is torn and frayed, which is known as a bankart lesion. If either a bankart lesion or a hillsachs lesion is diagnosed in a shoulder after anterior luxation, it is approximately 11 times more likely to find the second type of lesion than an isolated lesion. Any information contained in this pdf file is automatically generated from digital. Imaging methods for quantifying glenoid and hillsachs bone. Hagl lesion occurring after successful arthroscopic.
A hill sachs lesion occurs when the lesion to the labrum presents simultaneously puppy party. The incidence of hillsachs lesion is not known with certainty. Using medline pubmed, cochrane and embase databases we performed a search of all published articles. The indication for revision surgery was recurrent dislocation or subluxation. Jun 14, 2011 the arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. The american society of shoulder and elbow therapists. Repair of a slap lesion, which is an injury of the. Additionally, the labrum may slip off the face of the glenoid and no longer contributes to shoulder stability. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous bankart lesion repair. Intraoperative findings cases posterior capsuleligament lesion 2 intraarticular free body 1 slap lesion 6 enchondroma of the humeral head 1 fracturing of the anteroinferior glenoid rim 1 total 11 source. Slap superior labrum, anterior and posterior is a lesion that begins posterior in the labrum and extends anteriorly, involving the anchor of the long head of the biceps brachii to the labrum. This analogy is used because the articular surface of the round humeral head upper most part of the. 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. Pdf recurrent dislocation of the hip with a bankarttype.
Bankart ppt free download as powerpoint presentation. Perthes lesion is variant of bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped. This is because the articular surface of the round humeral head is approximately four times greater than that of the relatively flat shoulder blade face glenoid fossa1 figure 1. A computer search of electronic medical files at our hospital resulted in 66 consecutive patients with a shoulder stabilization revision operation performed between january 1, 2007 and december 31, 2011. Perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum. Pdf treatment of chronic anterior shoulder dislocation. A typical feature seen in reformatted en face images of the glenoid fossa is a flattening of the anterior counter.
Anatomic repair of this subsequent injury resulted in an excellent outcome. As a result of an accident in the gym, a dislocation of my left shoulder left me with pain, and also instability when my arm was raised above my head. Injured capsulolabral structures or bony glenoid fragments typically do not heal anatomically and can result in recurrent instability manifested by repeat dislocations or subluxations 4, 5, 8. A torn glenoid labrum results in shoulder instability. A hillsachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. The biceps anchor has pulled away from the glenoid attachment grade iv. We present a 34yearold male patient with pain and limited. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it.
Thirteen of fifteen patients with type iv or type v were failures in this study. In bankart repairs, the labral fragment is sutured back to the glenoid rim using suture anchors. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension. Open latarjet procedure for failed arthroscopic bankart repair. Bankart repair bankart lesion lesion of the anterior part of the glenoid labrum of the shoulder. This implies that intrinsic stability can be shared between the bankart repair and bone support. It is an indication for surgery and often accompanied by a hillsachs lesion, damage to the posterior humeral head. A report of 49 cases with a minimum 2year followup. We would like to report the 2 year clinical outcomes of bioabsorbable suture anchors used in traumatic anterior dislocations of the shoulder. Purpose of this study is to conduct a metaanalysis comparing the results of open and arthroscopic bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Rehabilitation guidelines for anterior shoulder reconstruction with open bankart repair. The bony apprehension test for instability of the shoulder. Manual reduction of the joint was carried out by hippocrates or rowe technique at least 3 times.
Mri revealed 6 osseous bankart lesions, 26 soft tissue bankart lesions 96%, and a hillsachs lesion in 25 92. The posterior bankart procedure is performed to increase posterior stability of the shoulder. Reverse bankart lesion is defined as the detachment of posteroinferior labrum with avulsion of posterior capsular periosteum. Arthroscopic bankart repair rehab protocol this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure.
Bankart repairanterior capsulorrhaphy rehabilitation guideline. In athletic patients under the age of 20 years, the recurrence rates are greater than 90%. A number of lesions are closely related have similar appearances, see anterior glenohumeral injury for discussion of the differences. Arthroscopic bankart repair anterior capsulorrhaphy procedure. Primary repair avoid high 5 low 5 positions if open repair1. Prepa re the bankart lesion by passing sutures and placing anchors, but do not. The incidence of anterior glenoid rim fractures has been reported to be up to 22% after first time anterior shoulder dislocation and up to 73% after recurrent dislocations 27. Video analysis of the mechanisms of shoulder dislocation in four elite rugby players. Arthroscopic repair of bony bankart lesions in collision athletes ncbi. The shoulder is a ball and socket joint, similar to the hip. There was recurrence of instability in two patients 7%. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. Choose from 2 different sets of bankart lesion flashcards on quizlet. This leads to laxity of posterior band of the inferior glenohumeral ligament with posterior displacement of the humeral head as is the case with a bankart lesion, the trauma may be severe enough to involve the bony glenoid, resulting in an accompanying small flake.
Repair of bankart lesions with masonallen suture provides increased labrum height. Ninety percent of shoulder dislocations are anterior, and traumatic injuries account for 95% of them4, 5, 6, 7. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation. This rehabilitation is generally the opposite of a bankart repair. The clinical files of the patients were examinated in order to document findings before, during and after the surgical procedure. Bankart repair anterior capsulorrhaphy rehabilitation guideline. To fully understand bankart lesions, we need to first understand the structure of the shoulder. A bony bankart is a bankart lesion that includes a fracture of. This analogy is used because the articular surface of the round humeral head upper most part of the arm is approximately four times. Repair of bankart lesion, which is a detachment of the aighlcapsulolabral complex from the anterior glenoid neck, usually caused by traumatic anterior dislocation. Hillsachs lesion hsl entirely covered by the glenoid at the sxchs ramhamadany and modi noted that an isolated hillsachs lesion increases the chances of a bipolar defect by a factor of 2. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon. Anterior shoulder reconstruction with arthroscopic bankart repair.
The physiologic groove in the humerus or cysts and erosions at the attachment site of the infraspinatus tendon can simulate a hillsachs, but usually this is not. Reverse hillsachs lesion is a defect caused by the anterior compression fracture of the humeral head in posterior shoulder dislocation. Jul 18, 2015 the threshold of glenoid bone loss above which arthroscopic bankart repairs may fail has generally been accepted as glenoid width loss. Each phase is adaptable based on the individual and special circumstances. These factors make it unlikely that a bankart tear heals. Long term results of arthroscopic bankart repair for. The arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. Learn bankart lesion with free interactive flashcards. Is clinical evaluation alone sufficient for the diagnosis. The coronal images shows the medially displaced labrum red arrow. Technical guide and tips on the allarthroscopic latarjet. In repair of a slap lesion, the labralbiceps complex is reattached. Bony bankart lesions have been associated with up to 30% of anterior dislocations 1 and consist of an avulsion fracture of the anterior glenoid rim.
Reverse bankart lesion radiology reference article. Jul 18, 2019 perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum. Original article arthroscopic versus open bankart repair in patients. Open capsular repair without bone block likely failures. A type v lesion is a completely degenerated or absent complex. This injury is caused by the labrum has a poor blood supply and joint fluid within the tear interferes with healing. Ct scan showing a bony bankart lesion at the anteroinferior glenoid. Grade ii or iv biceps involvement slap lesion repair grade ii. From engaging nonengaging to ontrack offtrack epos. Glenohumeral joint in abduction and external rotation in shoulder with glenoid defect and hillsachs lesion hs bipolar bone loss.
What links here related changes upload file special pages permanent. Arthroscopic view from the anterior portal in the right shoulder showing fiberwire coming from a. The physician will make specific changes to the program as appropriate for an individual patient. If coupled with a bankart repair, follow open bankart repair guidelines assumptions.
Dec 08, 2015 among the associated lesions, bankart lesions had the highest prevalence and were found in all the patients. Use inferior capsular flap to repair bankart lesion. Open latarjet procedure for failed arthroscopic bankart. Furthermore, all studies excluded patients with bony pathology, often cited as 2030% glenoid loss or as an engaging hillsachs lesion, but only a few studies have described the method used to assess bony pathology in detail. It has been reported to be present in 40% to 90% of patients presenting with anterior shoulder instability, that is subluxation or dislocation. In more severe cases when the labrum is torn a portion of the glenoid may be fractured and this is referred to as bony bankart lesion. Images were produced to provide en face views of the glenoid, allowing measurements. The bony lesions and glenoid bone loss was measured. Pdf arthroscopic bankart repair for the management of anterior. Shoulder, anterior dislocation, bankart repairmen, open surgery, arthroscopic surgery. Arthroscopic stabilization of anterior shoulder instability. The top of the arm bone head of the humerus forms the ball and the front part of the shoulder blade glenoid fossa forms the socket.
Evaluation of a treatment algorithm for acute traumatic. There is a positive correlation between the sizes of bankart and hillsachs lesions. A bankart lesion is an injury of the glenoid labrum due to an anteroinferior shoulder dislocation, often located in the 36 oclock position. Pdf treatment of reverse hillsachs lesion by autograft. Bankart lesions do heal, and therefore early surgical intervention if any is not required. Rehabilitation guidelines for slap lesion repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee figure 1. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously. It is an indication for surgery and often accompanied by a hillsachs lesion, damage to the posterior humeral head the bankart lesion is named after english.
This procedure included the injection of a contrast dye directly into the shoulder joint, followed by an m. Table 1 lesions associated with the bankart lesion. Arthroscopic doublepulley remplissage using a 2portal. The contribution of the hillsachs lesion to glenohumeral instability depends on the. Additional lesions such as a bankart, slap tear, or biceps injury may also be present. Here we will look at the common causes, associated injuries, symptoms and treatment options, both surgical and non surgical, for a bankart lesion labrum tear. The anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee figure 1. This protocol provides you with general guidelines for the postoperative rehabilitation of the patient following a reverse bankart posterior capsular shift repair.
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