Open vs arthroscopic repair for anterior shoulder instability. Traumatic injuries and repetitive overhead shoulder movements can tear the labrum, leading to pain, limited motion, instability and weakness in the joint. No passive forceful stretching into external rotationextension for 3 months following an anterior repair and into internal rotation for a posterior repair. Arthroscopic repair of this instability is the procedure of choice now a days. Pdf the purpose of this paper was to describe the results of arthroscopic. Arthroscopic bankart repair with suture anchors tips for. The purpose of this prospective randomized, double blinded controlled trial was to compare patientreported outcomes and clinical results between arthroscopic bankart repair with and without arthroscopic infraspinatus remplissage in patients with anterior shoulder instability with a hillsachs lesion.
In more severe cases when the labrum is torn a portion of the glenoid may be fractured and this is referred to as bony bankart lesion. May remove for dressing, hygiene, and tabletop use of hand, wrist, or elbow. Leave the little pieces of tape steristrips in place. There are parenthetical notes under this cpt code that instruct a coder to report 29806 for the arthroscopic procedure. The arthroscope uses a tiny camera to project a picture of your affected area onto a screen for your orthopedic surgeon to see. He also shares valuable surgical pearls and the evolution of his technique for managing hill.
Pdf the purpose of this study was to evaluate the results in selected. Arthroscopic mclaughlin procedure for treatment of. It is likely the injury pattern for dislocation changes as we age. Overview and recovery from a patients perspective doug letourneau is an avid basketball player in his free time. Bankart repair rehabilitation protocol arthroscopicopen. Arthroscopic rotator cuff repair is being performed by an increasing. The patients level of pain is not an accurate guage of healing and need for progression immediately post operative the patient will be placed in an immobilizer for four weeks. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic anterior stabilization procedure. Failure to recognize and address large hill sachs defects during arthroscopic stabilization surgery for glenohumeral instability is.
Patients with additional surgery will progress at different rates. Arthroscopic view of the bankart lesion in the left shoulder of patient in the. Shoulder dislocation and bankart repair sports medicine. The bankart repair did not restore the mechanical stability compared to the physiologic shoulder group. Pdf arthroscopic bankart repair using suture anchors in athletes. Arthroscopic transosseous bony bankart repair article pdf available in arthroscopy techniques 41 february 2015 with 345 reads how we measure reads.
Arthroscopic transosseous bony bankart repair matthew d. Never miscode bankart procedures again thanks to cpt. Pdf arthroscopic repair of posterior bony bankart lesion. Arthroscopic slapbankart repair protocol andrea saterbak, md phase i. Restoration of glenoid bony integrity is critical to minimizing the risk of recurrence and recreating normal kinematics in the setting of anterior glenohumeral instability. This portal can be used for anchor placement for slap lesions with a significant anterior extension and for suture management during repair of posterior slap lesions. Arthroscopic bankart repair with suture anchors tips for success. Avoid any internal rotation of the glenohumeral joint. In the course of this discussion, the relevant anatomy, the patients intraoperative experience as related to mercy hospital, springfield, massachusetts, and the complications and rehabilitative processes of this type of reostruction will be presented. Pdf arthroscopic treatment of the first anterior shoulder. The repair is generally done through a minimally invasive approach called arthroscopic surgery.
You will go to the recovery room and generally will be discharged after 12 hours. Front view of the right shoulder bankart repair operation what is it. Information for patients arthroscopic bankart repair. Rehabilitation protocol for bankart repair this protocol is intended to guide clinicians and patients through the postoperative course of a bankart repair. Achieving the criteria of each phase should be emphasized more than the approximate duration. The purpose of this prospective randomized, double blinded controlled trial was to compare patientreported outcomes and clinical results between arthroscopic bankart repair with and without arthroscopic infraspinatus remplissage in patients with. This technical description and video present a modern arthroscopic technique for bankart repair used.
A new arthroscopic subscapularis augmentation has recently been described that. Bankart repair rehabilitation protocol arthroscopicopen this protocol was developed for patients who have had a bankart repair. Arthroscopic bankart repair manhattan orthopedic care. Arthroscopic bankart repair with suture orthopaedic foundation. Remove the outer dressing on the second day after surgery and shower. The bankart repair for shoulder instability has evolved from open reconstruction to minimally invasive arthroscopic techniques, which have the benefit of less pain and morbidity. By midwest orthopaedics at rush featuring brian cole. The non anatomical repair aims at stabilizing the shoulder girdle by compensating for the capsular and labral tears with. The most predictable factor for the functional return was preoperative range of external rotation r.
Comparison of arthroscopic treatment with conservative treatment. Md appointment at 4 weeks, discharge sling if approved by md. Arthroscopic salvage of failed arthroscopic bankart repair. The critical point to to keep the shoulder muscles loose and relaxed. Case series of the use of primary arthroscopic bankart. Outcomes of bankart repairs using modern arthroscopic technique in an athletic population article pdf available in arthroscopy the journal of arthroscopic and related surgery 327 march 2016. Rehabilitation after arthroscopic posterior bankart repair. May have sling and swathe brace off four times daily for active hand, wrist, and elbow rom. Risk factors for hospital admission following arthroscopic. Brady performs an arthroscopic knotless bankart repair and discusses the benefits of using an interconnected knotless suturebridge technique for insetting the infraspinatus into the hill. Although the ama once advised coders to use 29807 arthroscopy, shoulder, surgical. As technology continues to improve, surgeons must regularly reevaluate techniques to improve efficacy and outcomes.
Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Brady, md, knoxville, tn discusses the arthroscopic bankart repair and knotless remplissage by presenting a case study of glenohumeral instability with repair portal placement posterior viewing portal. Never miscode bankart procedures again thanks to cpt 2004. The doctors will discuss your individual surgery with you before the operation. Arthroscopic rotator cuff repair rehabilitation guidelines derek plausinis, masc, md, frcsc 0 to 6 weeks postop sling use. It lines the shoulder socket and helps keep the ball of the humerus in place. Postoperative protocol anterior shoulder instability this procedure is normally the result of extreme laxity in the anterior capsule requiring surgical intervention to shrink the area. This is an operation to reattach the capsule and ligaments of your shoulder and prevent partial or complete dislocation. The effect of the arthroscopic augmentation of the subscapularis. If you have questions, contact the referring physician. You can get the wound wet after 2 days in a shower, but do not soak in a tub.
The large bony bankart fragment is mobilized, and 2 tunnels are drilled through the fragment from posterior to anterior using a 0. Arthroscopic transosseous bony bankart repair performed in a right shoulder in the lateral decubitus position. On the humeral side, a reverse hillsachs lesion rhsl is known to be engaging when it is over 20% to 25% of the articular surface in size. Arthroscopic slapbankart repair protocol andrea saterbak. Arthroscopic posterior bankart repair tmi sports medicine. Location is the same as described for bankart repair. Each phase is adaptable based on the individual and special circumstances. This arthroscopic shoulder surgery is used to repair a detached labrum.
Arthroscopic bankart repair with knotless remplissage. Setup and positioning we perform shoulder arthroscopy with the patient on a bean bag in the lateral decubitus position because we feel this provides optimum exposure for instrument place ment and allows for distraction of the glenohumeral. Arthroscopic anterior stabilization with or without bankart repair. When he dislocated his shoulder during a game, he wanted to treat his injury as quickly as possible and get back on the court. Petterson, phd anterior instability treated by arthroscopic surgery is a viable option to return the athlete. Shoulder dislocation and bankart repair desio sports. The arthroscopic bankart repair using the suture anchor is not indicated in multidirectional instability. Outcomes of bankart repairs using modern arthroscopic. In some instances, an open procedure is performed in which the muscles are separated to expose the shoulder. Passive and active assisted flexion out to the scapular plane as tolerated cane exercises, wall walking,table slide. The birdbeak evolution has a uniquely designed handle that allows for easy operation from.
Arthroscopic stabilisation bankart repair this procedure involves repairing the over stretched or torn labrum and capsule deep within the shoulder joint. Arthroscopic bankart repair center for sports medicine. Anterior shoulder reconstruction with arthroscopic bankart repair. Arthrex arthroscopic bankart repair with knotless remplissage. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 3. The unstable shoulder joint can be repaired by reattaching the torn labrum and capsule to the glenoid rim. Program and abstracts of the 67 th annual meeting of the american academy of orthopaedic surgeons. Good posture is critical throughout the rehabilitation process to improve healing and decrease the risk of developing poor mechanics.
Oct 24, 2015 arthroscopic orthopedic surgical video of bony bankart stabilization of anteriorinferior glenoid fracture of the shoulder for traumatic shoulder dislocation from san francisco orthopaedic sports. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 0. Arthroscopic bankart repair the socket of the shoulder, or glenoid, is covered with a layer of cartilage called the labrum that cushions and deepens the socket to help stabilize the joint. Arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note. Arthroscopic slapbankart repair protocol andrea saterbak, md.
Chattanooga, tn 423 6242696 postoperative instructions you will wake up in the operating room. Sports medicine arthroscopy joint replacement keith meister, md sports medicine arthroscopy head team physician texas rangers arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note. Pdf posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. The birdbeaks are an essential tool for arthroscopic labral, slap or rotator cuff repair. Jan 11, 20 arthroscopic repair of this instability is the procedure of choice now a days. Bankart repair, arthroscopic open revised august 2008 postop days 1 7 sling x 6 weeks even while sleeping place pillow under shoulder arm while sleeping for comfort hand squeezing exercises elbow and wrist active motion arom with shoulder in neutral position at side supported pendulum exercises. The labrum is a thick band of cartilage attached to the glenoid. Essential to the success of the arthroscopic bankart repair is protection of the capsule and static stabilizers of the glenohumeral joint. Soft tissue mobilization to surrounding musculature, initiate scar mobilization to surgical incisions if completely closed. The surgeon staples the detached part of your shoulder capsule, ligaments and labrum back into position. Aerobic conditioning throughout the rehabilitation process.
It is not intended to be a substitute for ones clinical decision. Traumatic glenohumeral bone defects and their relationship. Arthroscopic bankart repair boston sports medicine. Do not even measure internal rotation at the time of initial evaluation. We prefer to perform the surgery arthroscopically keyhole, but some surgeons prefer an open procedure. Arthroscopic orthopedic surgical video of bony bankart stabilization of anteriorinferior glenoid fracture of the shoulder for traumatic shoulder dislocation from san francisco orthopaedic sports. Anterior instability of the shoulder after trauma semantic scholar. It has been demonstrated here in association with smith and nephew inc. By hospital for special surgery featuring david w altchek. Arthroscopic bankart repair with and without arthroscopic. Arthroscopic bankart repair this procedure accesses the front of your shoulder by inserting a thin, flexible tube called an arthroscope through a small incision. The anchor provides the ability to independently pass the suture through a desired. Repair of a bankart lesion can be accomplished by either an open procedure or arthroscopic technique.
Arthroscopic bankart repair using suture anchors sciencedirect. Arthroscopic stabilisation bankart repair shoulderdoc. Rate of progression based on evaluation of the patient no excessive er, extension or elevation continue isometrics and rhythmic stabilization submax core stabilization program initiate scapular strengthening program. Franceschi f, longo ug, ruzzini l, rizzello g, maffulli n, denaro v. Outcome analysis of arthroscopic bankart repair using suture anchors. The birdbeak has an extremely sharp tip to penetrate soft tissue easily and a stiff shaft that resists bending during tissue shifting procedures. Feb 02, 2015 arthroscopic transosseous bony bankart repair performed in a right shoulder in the lateral decubitus position. Rate of progression based on evaluation of the patient no excessive er, extension or elevation.
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