- Discussion:
- is an avulsion of the anteroinferior glenoid labrum at its attachment to
IGHL complex;
- lesion is felt to result from
anterior shoulder dislocation and is felt to be primary lesion in
recurrent anterior instability;
- when Bankart lesion occurs, there is obligitory concomitant capsular disruption, w/ stretching or elongation of the
IGHL;
- in upto 30% of patients the IGHL will heal in a redundant position;
-
diff dx:
- glenoid labrum has many variations;
- fraying is the most common and often does not indicate pathology;
- anterior glenoid defect:
- in the experimental study by Itoi MD. et al. (JBJS 2000), the authors studied the role of an anterior gleoid defect (after Bankhart repair) on anterior instability;
- they found that an osseous defect with a width that is at least 21 % (about 7 mm) of the glenoid length may cause instability and limit the range of motion
of the shoulder after Bankart repair;
-
antero-superior labral anomalies:
- congential anomalies of labrum are often seen in its anterior and superior portion;
- isolated lesions of the anterosuperior portion of the labrum which do not involve the biceps brachii,
will not cause significant changes in anteroposterior or superoinferior glenohumeral translation;
- surgical debridment is not indicated;
- labral lesions which extend from the anterosuperior portion of the labrum to the biceps
insertion will result in significant changes in glenohumeral translation;
- Hagl Lesion:
- avulsion of inferior ligament from the humerus;
- Exam: Rotatory Stress Test:
- Radiographs:
-
West Point Axillary View: may identify bony Bankhart;
-
Stryker Notch
- MRI of the Shoulder:
- reference:
- MR imaging of the labral-capsular complex: Normal variations. CH Neumann et al.
Am J. Roentgenol. Vol 157. 1991. p 1015-1021.
- CT and MR evaluation of the labral capsular ligamentous complex of the shoulder.
Coumas JM. et al.
AJR Am J Roentgenol 1992;158:591-7.
- Anterior Shoulder Reconstruction:
-
axillary surgical approach:
-
bankart lesion fixation techniques:
- Arthroscopic Shoulder Reconstruction:
Congenital anteroinferior instability treated by Bankart repair.
Analysis of Bankart lesion in the recurrent dislocation or subluxation of the shoulder.
Recurrent anterior dislocation of the shoulder. Long-term follow-up of the Putti-Platt and Bankart procedures.
Recurrent anterior dislocation of the shoulder. Results after the Bankart and Putti-Platt operations.
The Bankart procedure: a long-term end-result study.
Biomechanical evaluation of a simulated Bankart lesion.
Modification of the Bankart reconstruction with a suture anchor. Report of a new technique.
Bankart Repair for Anterior Instability of the Shoulder. Long Term Outcome.
T.J. Gill MD, L.J. Micheli MD, F. Gebhard, C. Binder. JBJS Vol 79-A No 6. June 1997. p 850.
A mechanical evaluation of a simulated Bankart lesion.
KP Speer et al.
JBJS-Am. Vol 76. 1994. p 1819-1826.
The Effect of a Glenoid Defect on Anteroinferior Stability of the Shoulder After Bankart Repair: A Cadaveric Study*
E Itoi MD. et al.
JBJS. Vol 82-A. Jan 2000 No 1. p 35.
