This operation is performed for patients with a dislocating shoulder (the ball of the humerus comes out of the socket) . When the shoulder dislocates the lining of the shoulder (capsule and ligaments) is stretched and a wedge shaped piece of fibrous tissue is usually detached from the edge of the front of the socket of the shoulder known as a bankart lesion (or torn labrum).

The picture shows detachment of the labrum from the front of the socket.

Procedure

Surgery is carried out arthroscopically (key hole) to reattach the labrum and retension the stretched capsule and ligaments. All the operation is done inside the body with the surgeon viewing the operation from a television monitor. Using  small holes, suture anchors are put into the bone which have stitches attached. These stitches are then passed through the tissues to reattach the labrum and capsule to the front of the socket.

The illustrations a torn labrum being repaired.

Special instruments are used to pass the stitches through the labrum. This recreates the bumper effect of the labrum and deepens the socket. It also tightens the capsule and ligaments, all of which keeps the ball in joint. This creates a temporary hold, time is required for the body to create a biological bond for healing to occur.

The surgery is usually carried out as a day case.

Postoperative care

The patient will wear a sling for up to 4 weeks and pendular exercises straight away. Active assisted exercises will start at 4 weeks. For more detailed protocols click here.

Andrew Brooksbank