Bankartlesion

A Bankart lesion is an injury to the anteroinferior portion of the glenoid labrum of the shoulder, typically resulting from a traumatic anterior dislocation. It involves detachment of the labrum—and often the associated glenohumeral ligaments—from the rim of the glenoid. When a fragment of the glenoid rim is pulled off with the labrum, the lesion is referred to as a bony Bankart lesion. The lesion is named after Sir Arthur Bankart, who described it in the early 20th century.

Pathophysiology and associations: The injury usually occurs during forced abduction and external rotation of the shoulder and is a common finding in recurrent anterior shoulder instability, especially in young or contact-sport athletes. It frequently coexists with other injuries such as a Hill-Sachs lesion on the humeral head. The presence and extent of bone loss influence treatment strategy, with bone loss sometimes requiring procedures beyond soft-tissue repair.

Clinical presentation and diagnosis: Patients typically report a history of traumatic shoulder dislocation with subsequent episodes of instability or giving-way sensation. On examination, anterior shoulder instability with apprehension is common, and provocative tests may include anterior apprehension and relocation maneuvers. Imaging with MRI arthrography is highly sensitive for labral detachment; CT scanning or MRI can assess associated bone loss to guide management.

Management: First-time dislocations may be managed nonoperatively with immobilization and rehabilitation, though recurrence risk remains in younger patients. Recurrent instability due to a Bankart lesion commonly warrants surgical repair, most often an arthroscopic Bankart repair using suture anchors to reattach the labrum and ligaments to the glenoid rim. In cases with substantial glenoid bone loss, bony procedures such as the Latarjet can be considered. Postoperative rehabilitation is crucial for restoring range of motion and strength.

Prognosis: With appropriate repair, many patients regain function and stability, but recurrence risk persists, particularly in contact athletes or those with substantial bone loss. Complications may include stiffness, recurrent instability, or, less commonly, infection or nerve injury.