Bankart lesion

A Bankart lesion is a type of shoulder injury that occurs following a dislocated shoulder.[1] It is an injury of the anterior (inferior) glenoid labrum of the shoulder.[2] When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head.[3]

Bankart lesion
The glenoid labrum, labeled glenoid ligament, is damaged in a Bankart lesion. Lateral view demonstrating the articular surface of the right scapula is shown.

A bony Bankart is a Bankart lesion that includes a fracture of the anterior-inferior glenoid cavity of the scapula bone.[4]

The Bankart lesion is named after English orthopedic surgeon Arthur Sydney Blundell Bankart (1879–1951).[5]

Signs and symptoms

Diagnosis

The diagnosis is usually initially made by a combination of physical exam and medical imaging, where the latter may be projectional radiography (in cases of bony Bankart) and/or MRI of the shoulder. The presence of intra-articular contrast allows for better evaluation of the glenoid labrum.[6] Type V SLAP tears extends into the Bankart defect.[7]

Treatment

Arthroscopic repair of Bankart injuries have good success rates, though nearly one-third of patients require further surgery for continued instability after the initial procedure in a study of young adults, with higher re-operation rates in those less than 20 years of age.[8] Options for repair include an arthroscopic technique or a more invasive open Latarjet procedure,[9] with the open technique tending to have a lower incidence of recurrent dislocation, but also a reduced range of motion following surgery.[10]

  • X-ray at left shows anterior dislocation in a young man after trying to get up from his bed. X-ray at right shows same shoulder after reduction and internal rotation, revealing both a bony Bankart lesion and a Hill-Sachs lesion.
    X-ray at left shows anterior dislocation in a young man after trying to get up from his bed. X-ray at right shows same shoulder after reduction and internal rotation, revealing both a bony Bankart lesion and a Hill-Sachs lesion.
  • CT scan showing a bony Bankart lesion at the antero-inferior glenoid
    CT scan showing a bony Bankart lesion at the antero-inferior glenoid
  • MRI of the shoulder after an anterior dislocation showing a Hill-Sachs lesion and labral Bankart lesion
    MRI of the shoulder after an anterior dislocation showing a Hill-Sachs lesion and labral Bankart lesion
  • Bankart lesion seen at arthroscopy
    Bankart lesion seen at arthroscopy
  • Radiograph showing a bony Bankart lesion with stationary fragment at the inferior glenoid
    Radiograph showing a bony Bankart lesion with stationary fragment at the inferior glenoid
  • 3-D CT reconstruction of a bankart lesion which occurred post anterior shoulder dislocation. This subject's humerus remains mildly superiorly subluxated. Fracture marked by a black arrow.
    3-D CT reconstruction of a bankart lesion which occurred post anterior shoulder dislocation. This subject's humerus remains mildly superiorly subluxated. Fracture marked by a black arrow.

See also

References
  1. Major, Nancy M.; Anderson, Mark W. (2020). "10. Shoulder". Musculoskeletal MRI. Philadelphia: Elsevier. pp. 218–219. ISBN 978-0-323-415606.
  2. Widjaja A, Tran A, Bailey M, Proper S (2006). "Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation". ANZ Journal of Surgery. 76 (6): 436–8. doi:10.1111/j.1445-2197.2006.03760.x. PMID 16768763. S2CID 42257934.
  3. Porcellini, Giuseppe; Campi, Fabrizio; Paladini, Paolo (2002). "Arthroscopic approach to acute bony Bankart lesion". Arthroscopy: The Journal of Arthroscopic and Related Surgery. 18 (7): 764–769. doi:10.1053/jars.2002.35266. ISSN 0749-8063. PMID 12209435.
  4. "bony Bankart at The Steadman Clinic Vail, CO. © 2001 by LeadingMD". Archived from the original on 2011-07-26. Retrieved 2011-05-16.
  5. Who Named It.com - Bankart's Lesion
  6. Jana, M; Srivastava, DN; Sharma, R; Gamanagatti, S; Nag, H; Mittal, R; Upadhyay, AD (April 2011). "Spectrum of magnetic resonance imaging findings in clinical glenohumeral instability". The Indian Journal of Radiology & Imaging. 21 (2): 98–106. doi:10.4103/0971-3026.82284. PMC 3137866. PMID 21799591.
  7. Chang, D; Mohana-Borges, A; Borso, M; Chung, CB (October 2008). "SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization". European Journal of Radiology. 68 (1): 72–87. doi:10.1016/j.ejrad.2008.02.026. PMID 18499376.
  8. Flinkkilä, T; Knape, R; Sirniö, K; Ohtonen, P; Leppilahti, J (16 March 2017). "Long-term results of arthroscopic Bankart repair: Minimum 10 years of follow-up". Knee Surgery, Sports Traumatology, Arthroscopy. 26 (1): 94–99. doi:10.1007/s00167-017-4504-z. PMID 28303281. S2CID 6692528.
  9. Zimmermann, SM; Scheyerer, MJ; Farshad, M; Catanzaro, S; Rahm, S; Gerber, C (7 December 2016). "Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure" (PDF). The Journal of Bone and Joint Surgery. American Volume. 98 (23): 1954–1961. doi:10.2106/jbjs.15.01398. PMID 27926676. S2CID 24940288.
  10. Wang, L; Liu, Y; Su, X; Liu, S (8 October 2015). "A Meta-Analysis of Arthroscopic versus Open Repair for Treatment of Bankart Lesions in the Shoulder". Medical Science Monitor. 21: 3028–35. doi:10.12659/msm.894346. PMC 4603609. PMID 26446430.
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