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A Bankart lesion is a common injury to the cartilage in the shoulder joint, specifically the glenoid labrum. This injury is often associated with shoulder dislocations, which are the most common type of shoulder injury, affecting about 1% of the population. The shoulder is a ball-and-socket joint, and during a dislocation, the humeral head can push against the glenoid labrum, tearing the cartilage. This tear is known as a Bankart lesion or Bankart tear, and it can leave the shoulder unstable and prone to further dislocations. Treatment options for Bankart lesions include surgery, physical therapy, or both, with the goal of repairing the torn labrum and restoring shoulder function.
| Characteristics | Values |
|---|---|
| Bankart Lesion | An injury commonly associated with a dislocated shoulder |
| A tear in the cartilage in the shoulder joint | |
| A common complication of anterior shoulder dislocation and/or repeated anterior shoulder subluxations | |
| A tear in the lower rim of the labrum (tough, flexible tissue) of the shoulder | |
| A glenoid labrum tear in the anterior joint | |
| Treatment | Non-surgical methods such as rest, immobilization, and physical therapy |
| Surgical repair to re-attach the torn labrum | |
| Arthroscopic Bankart repair | |
| Open Bankart repair |
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What You'll Learn
Bankart lesions are tears in the shoulder's cartilage
A Bankart lesion is a tear in the cartilage of the shoulder. The shoulder is a ball-and-socket joint, with the ball (or "head") of the arm bone (humerus) resting in a shallow socket called the glenoid. The outer rim of the glenoid is ringed by tough, flexible tissue called the labrum. An injury to the labrum can result in a Bankart lesion.
Bankart lesions are injuries of the anteroinferior aspect of the glenoid labral complex. They are commonly associated with a Hill-Sachs lesion and are a frequent complication of anterior shoulder dislocation and/or repeated anterior shoulder subluxations. The dislocation of the shoulder joint can damage the connective tissue ring around the glenoid labrum and also affect the connection between the labrum and capsule. This injury is often seen in athletes who play volleyball, tennis, or handball, or those who perform overhead activities.
During a shoulder dislocation, the humeral head is pushed against the anterior glenoid labrum at the front of the socket, tearing it. This is called a glenoid labrum tear, or a Bankart tear. Once the labrum is torn, there is a higher risk of recurrent dislocation. Bankart lesions are often the result of high-energy trauma and sports injuries, either acute or from overuse. They are most common among people in their twenties, but they can occur at any age.
There are two types of Bankart lesions: soft and bony. A soft Bankart lesion involves the labrum tearing from the glenoid, with the injury affecting only the soft tissue. A bony Bankart lesion involves the labrum tearing and a part of the bony glenoid fracturing or breaking off, which can lead to notable bone loss in the glenoid and cause chronic instability.
Treatment for a Bankart lesion will depend on the patient's age, expectations, and sporting involvement. Young patients involved in contact sports will typically be considered for surgery. In Bankart repairs, the labral fragment is sutured back to the glenoid rim using suture anchors. However, non-surgical methods such as rest, immobilization, and physical therapy may also be used, especially in older patients.
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They occur when the shoulder dislocates
The Bankart lesion or injury refers to an anatomical disruption of the anterior-inferior glenoid labrum, which is a fibrous cartilage rim that surrounds the socket of the shoulder joint. It typically occurs when the head of the humerus (upper arm bone) dislocates out of the socket, tearing this labrum. The lesion is often seen in young, active individuals who experience a traumatic anterior shoulder dislocation, where the humeral head moves out of the socket at the front. During this dislocation, the humeral head impacts and avulses the labrum from the glenoid bone. A Bankart injury can cause ongoing shoulder instability, with the risk of recurrent dislocations. The lesion is treated through surgical repair, which aims to restore the stability and function of the shoulder joint.
When the shoulder dislocates, specifically in an anterior direction, the humeral head moves out of the socket and can cause significant damage to the surrounding soft tissues and structures. The anterior-inferior glenoid labrum, which is part of the fibrous joint capsule, is particularly vulnerable. The labrum functions to deepen the socket and provide stability to the ball-and-socket joint. A Bankart injury occurs when the anterior-inferior glenoid labrum is torn, often with a small fragment of bone still attached. This tear typically occurs at the labrum's attachment to the glenoid bone.
The mechanism of injury for a Bankart lesion is a forceful traction or pulling injury to the shoulder. This can happen when the arm is forcefully abducted (moved away from the body) and externally rotated, as may occur in sports like rugby or football, for example, during a tackle. The injury can also happen during a fall on an outstretched hand, or a direct blow to the shoulder, such as a collision in contact sports. The direction of force and the position of the arm during the impact contribute to the labrum tear pattern seen in a Bankart lesion.
Young, active individuals are particularly susceptible to Bankart injuries due to the hypermobility of their shoulder joints. The first episode of dislocation often occurs during sports or other physical activities. Once the initial dislocation has occurred, the risk of recurrence is high, and the shoulder may become unstable, with the possibility of subsequent dislocations. This is because the torn labrum results in increased joint laxity, and the shoulder may feel loose or 'pop out' repeatedly.
The diagnosis of a Bankart lesion involves a thorough physical examination, including specific tests to assess shoulder instability and range of motion. Imaging techniques, such as X-rays, MRI, or CT scans, may also be utilized to visualize the labrum and confirm the presence and extent of the tear. An accurate diagnosis is crucial for determining the appropriate treatment approach. Nonsurgical management may be considered for first-time dislocations without significant instability.
The standard treatment for a Bankart lesion is often surgical repair, especially in cases of recurring dislocations. Arthroscopic surgery, a minimally invasive technique, is commonly employed. During the procedure, the torn labrum is reattached to the glenoid bone using suture anchors. This surgical repair helps restore the stability and function of the shoulder joint, reducing the risk of recurrent dislocations. Postoperative rehabilitation is also crucial for a successful outcome, involving a gradual range-of-motion and strengthening program to ensure a full recovery.
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The injury can be treated with surgery or physical therapy
A Bankart lesion is an injury to the anteroinferior aspect of the glenoid labral complex. It is a common complication of anterior shoulder dislocation and/or repeated anterior shoulder subluxations. This injury is common in athletes who play volleyball, tennis, handball, or those who perform overhead activities. It can also occur in contact sports such as football, soccer, water polo, or rugby, especially when the arm is above the head.
The injury is caused when the humerus is compressed against the labrum, which can happen during anterior shoulder dislocations or subluxations. This compression can cause the labrum to tear and detach from the underlying glenoid. There are two types of Bankart lesions: soft and bony. A soft Bankart lesion involves only the soft tissue, while a bony Bankart lesion involves a fracture of the bony glenoid, which can lead to bone loss and chronic instability.
The treatment for a Bankart lesion depends on various factors, including the patient's expectations, age, and sporting involvement. Young patients involved in contact sports are more likely to be considered for surgery. During surgery, the labral fragment is sutured back to the glenoid rim using suture anchors. However, it is important to note that even with surgery, there is still a chance of recurrence.
For patients who do not require surgery, physical therapy can be an effective treatment option. This typically involves immobilizing the shoulder and arm in a sling for a few weeks, followed by a gradual rehabilitation program that includes shoulder exercises. The recovery process can take around 4-6 months, and most patients are able to return to their pre-injury activity levels.
In conclusion, a Bankart lesion is a serious injury that can compromise the stability of the shoulder joint. While surgery is often considered the primary treatment option, especially for young athletes, physical therapy can also be effective in treating this injury and helping patients regain their range of motion and strength.
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It is common among athletes in volleyball, tennis and handball
A Bankart lesion is a common injury associated with a dislocated shoulder. The shoulder is a ball-and-socket joint made up of the humeral head of the upper arm bone and the shoulder socket on the shoulder blade. The shoulder joint is enclosed by a capsule made up of ligaments and other tough fibres. During a shoulder dislocation, the humeral head forcefully pushes against the anterior glenoid labrum at the front of the socket, causing a tear. This tear in the anterior joint is called a Bankart lesion or a Bankart tear.
Bankart lesions are common among athletes in volleyball, tennis, and handball due to the repetitive overhead motions involved in these sports. The spike and jump serve in volleyball, for example, involve a significant amount of force and torque, which can lead to overuse injuries in the shoulder. Similarly, in tennis, the repetitive overhead motions required for serving and hitting can also lead to similar overuse injuries. Handball also involves a lot of overhead throwing and shooting motions, which can put stress on the shoulder joint.
In addition to the repetitive nature of these sports, the risk of injury is also heightened due to the high energy and impact involved. High-energy trauma and sports injuries are common reasons for Bankart tears. The force generated during a spike in volleyball or a serve in tennis, for example, can result in significant stress on the shoulder joint, increasing the risk of dislocation and subsequent Bankart lesions.
To prevent and manage Bankart lesions in these athletes, various approaches can be considered. Physical therapy and strengthening exercises can help improve muscle tissue health and increase the range of motion in the shoulder. Additionally, a shoulder injury prevention program focused on rotator cuff and scapular strength and stabilization can be beneficial in reducing the risk of upper extremity injuries. In some cases, surgery may be recommended, especially for young patients involved in contact sports. However, the decision to undergo surgery or opt for non-operative management depends on various factors, including patient expectations, age, and sporting involvement.
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The shoulder is a ball and socket joint
Bankart lesions are a common complication of anterior shoulder dislocation or repeated subluxations. They are often associated with athletes who play volleyball, tennis, or handball, or those who perform overhead activities. The injury can also cause damage to the connection between the labrum and capsule, as well as the medial glenohumeral ligament. In some cases, a Bankart lesion may occur without dislocation due to muscular weakness and ligamentous laxity, resulting in multiple dislocations in different directions.
The treatment for a Bankart lesion depends on the patient's age, sporting involvement, and the severity of the injury. Non-surgical methods such as rest, immobilization, and physical therapy may be sufficient for older patients or those with stable shoulders. However, surgery may be required to reattach the labrum to the shoulder socket, especially for young patients involved in contact sports. The torn tissue is sewn back to the rim of the socket using suture anchors, and arthroscopic repair can help regain muscle strength faster. Physiotherapy prior to and after surgery is crucial for strengthening the joint, preventing further dislocations, and maximizing rehabilitation potential.
To diagnose a Bankart lesion, a physical examination may not be sufficient. Magnetic Resonance Imaging (MRI) or x-rays may be necessary to confirm the tear and assess any bony lesions or nerve injuries. Once diagnosed, a Bankart repair procedure can be performed to re-attach the torn labrum and restore the anatomy of the shoulder. This involves roughening the edge of the glenoid socket, drilling small holes, and passing sutures through the detached labrum and ligaments to secure them back to the socket.
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