Additionally, the labrum may slip off the face of the glenoid and no longer contributes to shoulder stability. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously. They also found a slightly higher reoperation rate for the bankart procedure 12% versus 8%, p 0. Combined allarthroscopic hillsachs remplissage, latarjet. The significance of the alpsa lesion to the arthroscopist is that the labrum and attached ligaments, rather than floating free, heal in an abnormal position and eventually resynovialize, and may be difficult to identify as abnormal at the time of. Shoulder instability includes different degrees of instability from painful hyperlaxi. This injury is caused by the labrum has a poor blood supply and joint fluid within the tear interferes with healing.
Traumatic unidirectional bankart lesion surgical repair. Study of bipolar bone defects in unstable shoulder. The contribution of the hillsachs lesion to glenohumeral instability depends on. Any information contained in this pdf file is automatically generated from. 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. Data from 79 shoulders in 74 patients were collected over 4 years 2004 2008. This lesion has been referred to as the medialized bankart lesion. Arthroscopic repair of a posterior bony bankart lesion.
Bankart lesions are named after english orthopedic surgeon arthur sydney blundell bankart, 18791951, who first described the injury and the surgical repair process. 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. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. Pdf results of arthroscopic bankart repair with hill.
Bankart repair bankart lesion lesion of the anterior part of the glenoid labrum of the shoulder. Arthroscopic repair of chronic bony bankart lesion using a. Long term results of arthroscopic bankart repair for. Better suited to open approach engaging hillsach lesions these lesions is more than 30%40% of the humeral head. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation. It may result either from a traumatic glenohumeral dislocation or a direct trauma to the adducted arm.
Transfer of the coracoid process in recurrent anterior instability of. Achieved staged rom limits but do not significantly exceed them. Pdf arthroscopic repair of combined bankart and slap. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. The choice between these procedures depends mainly on surgeon preference or training rather than published evidence. The open latarjet procedure is more reliable in terms of.
Large bony bankart lesion 25% of the articular surface smaller lesion can be excised and repair the labral ligament complex. Intraoperative findings and outcome of latarjet procedure. Humeral avulsion of glenohumeral ligament lesions this lesion very difficult to visualize arthroscopically. Schulterinstabilitaten deutsches gelenkzentrum heidelberg. The arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bioabsorbable suture anchors used in traumatic anterior dislocations of the shoulder.
Dislozierte knocherne bankartla sionen sind eine indikation zum. This challenge is enhanced when the lesion is chronic and fibrous malunion of the fragment makes mobilization difficult. Anterior stabilization bankart postoperative protocol dr kolowich, dr lock, dr rill, dr moutzouros phase i. Microbiological recommendations for the diagnosis and followup of infective endocarditis. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction. Operative techniques and clinical results article pdf available in clinics in orthopedic surgery 21. The anterior front labrum can peel off the glenoid. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension. Reverse bankart lesion radiology reference article.
Treatment of chronic anterior shoulder dislocation by open. Bankart lesion is the anterior glenohumeral instability most common associated injury. If you do not see its contents the file may be temporarily unavailable at the journal. Leitlinien unfallchirurgie neu entwickelte leitlinie awmf. Complete this form if you are a member onz a visiting force including its civilian component or a crew member of any craft transporting such people. Posterior humeral avulsion of the glenohumeral ligament. Treatment of a posterior hillsachs lesion in the right shoulder with a doublepulley remplissage. Download acrobat pdf file 7mb icmje author disclosure forms. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously with a.
Anterior shoulder instability has classically been treated with open or arthroscopic softtissue bankart repair, with failure rates between 3. We compared patients with recurrent posttraumatic anterior shoulder instability treated with arthroscopic. 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. Evaluation of a treatment algorithm for acute traumatic. The shoulder joint is made up of the glenoid and humeral head. Arthroscopic suture anchor fixation of bony bankart lesions. Results of arthroscopic bankart repair with hillsachs remplissage for anterior shoulder instability article pdf available in international orthopaedics 4112 may 2017 with 7 reads. We hypothesized that open reduction and simultaneous bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than. Media in category bankart lesion the following 5 files are in this category, out of 5 total. These factors make it unlikely that a bankart tear heals. Untreated chronic shoulder dislocation eventually leads to functional disability and pain. 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. If a lesion of 20% to 30% the width of the glenoid is present, arthroscopic repair of the bony bankart lesion is preferable to repair of the softtissue lesion alone.
Using medline pubmed, cochrane and embase databases we performed a search of all published articles. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon. Tears at glenohumeral ligaments can be intra substance or at humeral insertion, this location may be the cause of instability. Perthes lesion is variant of bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped. Learn from lesion experts like frontiers and jose a.
Posterior bony defects of the glenoid rim, particularly those associated with instability, are often a frustrating challenge for arthroscopists because of the defects inaccessibility from standard portals. Arthroscopic bankart repair and open latarjet bone block procedure are widely considered mainstays for surgical treatment of recurrent anterior shoulder instability. Bankart and slap repair post operative pt protocol please contact the uwmc shoulder and elbow team with any questions. To aid stability of the joint, the glenoid has a soft tissue bumper around its edge the labrum which acts as a bumper preventing dislocation of the head from the glenoid pathology.
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. The osseous bankart lesion is an avulsion of the humeral labral complex with an anterior rim fracture. 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. Journal of orthopaedic surgery and research risk factors for shoulder redislocation after arthroscopic bankart repair hideaki shibata masafumi gotoh 0 yasuhiro mitsui 0 yoshihiro kai hidehiro nakamura tomonoshin kanazawa takahiro okawa 0 fujio higuchi 0 masahiro shirahama naoto shiba 0 department of orthopaedic. Perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum. Arthroscopic doublepulley remplissage using a 2portal. Langzeitergebnisse nach offener bankartneeroperation. This procedure included the injection of a contrast dye directly into the shoulder joint, followed by an m. A hillsachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases. A 30yearold man presents with recurrent anterior shoulder instability. Arthroscopic repair of combined bankart and slap lesions. Pdf fractures of the anteroinferior glenoid rim, termed bony bankart lesions, have been reported to occur in up to 22 % of first time anterior. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We present our technique for arthroscopic repair of the relatively.