Instability

Bankart lesion

Detachment of the anteroinferior labrum after dislocation. Bone variants (bony Bankart) worsen the prognosis.

The Bankart lesion is a detachment of the anteroinferior labrum from the glenoid, occurring in 80-95% of anterior dislocations of the shoulder. The glenoid labrum is a fibrocartilaginous ring that increases the depth and contact surface of the glenoid by 50%. Its lesion directly compromises the anterior stability of the shoulder. A distinction is made between the classic Bankart lesion (isolated capsulo-labral detachment) and the bony Bankart (fracture of the antero-inferior glenoid rim), the latter significantly worsening the prognosis and often requiring a Latarjet type intervention rather than an arthroscopic repair.

Characteristics

  • Episode(s) of anterior shoulder dislocation with residual apprehension in armed position (abduction + external rotation). Sensation of instability or “dead arm”.
  • Apprehension and refocusing test (Jobe): specificity > 90%. The patient feels acute apprehension in the cocked position, relieved by posterior pressure on the humeral head.
  • Arthro-MRI or arthro-scanner: visualization of the labral detachment, quantification of glenoid bone loss (bony Bankart if fragment > 5% of the glenoid surface).
  • Variants: ALPSA (Anterior Labral Periosteal Sleeve Avulsion — labrum detached but not mobile), Perthes (labrum detached under the intact periosteum), HAGL (humeral avulsion of the inferior glenohumeral ligament).

Medical and surgical management

  • Classic Bankart without significant bone loss: arthroscopic repair with 3-4 resorbable anchors. Reattaches the capsulolabral complex to the glenoid. Success rate 85-92%.
  • Bony Bankart (bone fragment < 20% of the glenoid): arthroscopic repair with anchors in the bone fragment or Latarjet if the fragment is too comminuted.
  • Glenoid bone loss > 20-25% (significant Bankart bony): Latarjet abutment rather than arthroscopic repair (recurrence rate too high with Bankart alone).

Physiotherapy rehabilitation

  • Post-operative Bankart arthroscopic: immobilization 4-6 weeks, pendulum exercises from D+3. Progressive passive mobilization in flexion. No external rotation beyond 0° for 6 weeks.
  • Progressive strengthening from 3 months: rotator cuff (external rotators in priority), deltoid, scapula fixators. Eccentric work.
  • Proprioception and dynamic stabilization: closed chain exercises, disturbances, work on an unstable plane. Neuromuscular reconditioning.
  • Return to contact sport/throwing: 6-9 months minimum. Specific progressive sports program. Functional assessment before recovery.

Average duration

12 to 24 weeks post-operative

Book appointment

Scientific sources

General information only: this content cannot provide a diagnosis or prescription. A healthcare professional must assess your situation.