Modified Bankart Repair in Capsular Reconstruction for Shoulder Instability

Since Neer's description of the capsular shift procedure in the surgical treatment of the unstable shoulder, capsular reconstruction has become the preferred procedure in the treatment of this pathology. Re-insertion of the labro-capsular complex must still be performed in the presence of a Bankart lesion. A prospective study was undertaken to test the effectiveness of a modified Bankart repair. 65 patients, average age 27 years with an average follow up of four years (range 2-5 years), in whom a Bankart lesion was observed during surgical stabilization of the shoulder, underwent a modified Bankart repair. Instead of suturing the labro-capsular complex to the glenoid rim, the horizontal limb of the T capsular incision, as part of the capsular shift, is extended medially to Include the labrum and the periosteum of the gleunid neck. After the glenoid neck is freshened the labrum and capsule are plicated and thereby shortened and tightly opposed to the glenoid neck and tim. A formal capsuloplasty is then performed. Results were excellent in 59 patients (91%) and good in 5 patients (7%), this was due to a loss of up to 15% of external rotation. One patient (2%) suffered recurrent subluxations. The results of the modified Bankart repair has been shown to be excellent and reliable. The technique permits simplification of the standard Bankart repair and preservation of glenoid articular cartilage by dispensing with the need for holes in the glenoid surface.