Arthroscopic bankart repair surgery northam shoulder. Rehabilitation guidelines for anterior shoulder reconstruction with arthroscopic bankart repair 333 38th st. Achieving the criteria of each phase should be emphasized more than the approximate duration. Chattanooga, tn 423 6242696 postoperative instructions you will wake up in the operating room.
The unstable shoulder joint can be repaired by reattaching the torn labrum and capsule to the glenoid rim. Most studies have reported good to excellent outcomes with little to no loss in range of movement and recurrence rates comparable with those of arthroscopic bankart repairs performed in. A report of 49 cases with a minimum 2year followup. When the shoulder joint is torn its common to have occurred due to a shoulder dislocation and instability. Arthroscopy with labrum repair including slap repair or bankart repair dr. The large bony bankart fragment is mobilized, and 2 tunnels are drilled through the fragment from posterior to anterior using a 0. Phase i immediate postoperative phase restrictive motion weeks 06 goals. Arthroscopic bankart repair boston sports medicine. Longterm outcomes following isolated arthroscopic bankart repair. Open bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent anterior instability of the shoulder a metaanalysis. Immediate postop through 4 weeks post op therapist assisted passive range of motion prom ok immobilize full time except pendulums and stick assisted external rotation er to 30. Shoulder dislocation and bankart repair sports medicine.
Pnf manual resistance dr tim dwyer orthopedic surgery of the k 647 707 7805 e47 ortho 1 x. Lacking evidence for rehabilitation following arthroscopic bankart repair. Rehabilitation guidelines for anterior shoulder reconstruction with open bankart repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to a golf ball on a tee figure 1. 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. The following is a guideline for progression of postoperative treatment. Arthroscopic bankart repair manhattan orthopedic care. Bankart repair anterior capsulorrhaphy rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Bankart arthroscopic anterior capsulolabral 6repair, m. Protect the anatomic repair prevent negative effects of immobilization promote dynamic stability and proprioception diminish pain and inflammation weeks 02 sling for 23 weeks for comfort. Arthroscopic anterior capsular shiftbankart repair weeks 12 objective is to protect healing capsule, allow early, graded, protected motion, prevent stiffness, minimize atrophy, and control pain and inflammation wear sling during the day for 34 weeks sleep in your sling for 34 weeks monitor neurovascular status. Arthroscopic bankart repair with suture orthopaedic foundation. You may use your hand on the operated arm as long as you do not raise the hand above your head or reach across the front of your body. As of july 1, 2016, and as further clarified in the updated national correct coding initiative ncci guidelines effective.
Each phase is adaptable based on the individual and special circumstances. Wolf md ms congdon professor and vicechair of orthopaedic surgery director of sports medicine. Arthroscopic bankart repair manual techniques scapular and gr iiiii ghj mobilizations posterior capsule stretching soft tissue massage initiate supine rhythmic stabilization at 90 flexion modalities ice, electrical stimulation phase iii week 712 prom, aarom, arom. It is designed for rehabilitation following arthroscopic bankart repair anterior capsulorrhaphy procedure. Encourage prom at home daily 2 3 sessions by family member for the first 6 8 weeks. Instead, this document should serve as a guideline and, as such, should be used in conjunction with a thorough history and physical examination of the individual patient. A variety of arthroscopic techniques have been described in the literature, commonly using the posterior portal for visualization and the anterior portal with a working cannula. You will go to the recovery room and generally will be discharged after 12 hours. Comparison of time to recurrence of instability after open. External websites may be referred to in specific cases. Arthroscopic repair of posterior bony bankart lesion and. Arthroscopic bankart repair is a procedure is used to repair a detached or overstretched labrum and capsule deep within the shoulder joint.
When he dislocated his shoulder during a game, he wanted to treat his injury as quickly as possible and get back on the court. Although the ama once advised coders to use 29807 arthroscopy, shoulder, surgical. Protect the anatomic repair prevent negative effects of immobilization promote dynamic stability decrease pain and inflammation weeks 0 to 4 sling for 4 weeks sleep in immobilizer for 4 weeks elbow and hand rom exercises. Rehabilitation after arthroscopic bankart repair and anterior stabilization procedures phase 0. Arthroscopic posterior bankart repair phase i protection phaseimmediate motion 0 6 weeks postop note. Information for patients arthroscopic bankart repair. In some instances, an open procedure is performed in which the muscles are separated to expose the shoulder. If procedure is performed arthroscopically strengthening of the rotator cuff.
The humeral head ball of the shoulder joint is centered in the glenoid the socket of the joint, which stabilizes the shoulder. Brady, md, knoxville, tn discusses the arthroscopic bankart repair and knotless remplissage by presenting a case study of glenohumeral instability with arthroscopicopen this protocol was developed for patients who have had a bankart repair. The suture first technique allows surgeons to independently pass suture through a desired amount of tissue prior to anchor. Lacking evidence for rehabilitation following arthroscopic. Immediate postoperative phase restrictive motion goals. Arthroscopic capsular plication arthroscopic bankart. The doctors will discuss your individual surgery with you before the operation. Arthroscopic bankart repair for the management of anterior. This analogy is used because the articular surface of the round humeral head upper most part of the arm is approximately four times. Bankart repair protocol vanderbilt university medical center. It is designed for rehabilitation following arthroscopic posterior bankart repair.
Arthroscopic labrum repair of the shoulder slap anatomy. Arthroscopic capsular plication arthroscopic bankart anterior labral repair postop rehabilitation phase i. Laith jazrawi performs an arthroscopic repair of a bony bankart lesion. This protocol is intended to provide physiotherapists with guidelines for the postoperative management of a patient who has undergone an arthroscopic bankart repair. Arthroscopic repair for initial anterior dislocation. Anterior shoulder reconstruction with arthroscopic bankart repair. Open bankart repair versus arthroscopic repair with.
Do not even measure internal rotation at the time of initial evaluation. For this reason the shoulder is the most mobile joint in the body. Location is the same as described for bankart repair. General information there may be a loss of external rotation when compared to the other side, but the motion is. Aerobic conditioning throughout the rehabilitation process. Postoperative instructions for shoulder arthroscopy with. The labrum is a thick band of cartilage attached to the glenoid. 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. Arthroscopic bankart repair protocol recommendations. The socket portion of the joint is not naturally deep. Arthroscopic anterior bankart repair rehab protocol. Slap repair portal placement posterior viewing portal. The american society of shoulder and elbow therapists. Summary table post op phasegoals range of motion therapeutic exercise precautions phase i.
Rehabilitation after arthroscopic posterior bankart repair. During arthroscopic bankart repair, penetration of suture anchors through the far cortex can compromise the initial biomechanical characteristics of anchor stability and repair integrity. Sling for 4 weeks may take off swathe when good arm control elbowhand rom and hand gripping exercises aarom. Surgery to repair a bankart lesion is often performed through arthroscopy.
Guidelines for weeks 0 to 6 draft university of washington. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. Bankart repair rehabilitation protocol arthroscopicopen this protocol was developed for patients who have had a bankart repair. It lines the shoulder socket and helps keep the ball of the humerus in place.
Guidelines for weeks 0 to 6 what to do talk with your provider, nurse, or physical therapist if you have any questions or concerns. The arthroscopic bankart repair progresses more conservatively than an open procedure due to fixation methods that initially postop may not be as stable. Arthroscopy is a minimallyinvasive technique that uses tiny incisions to insert a probelike camera, allowing the surgeon to fully examine the area before performing corrections. Arthroscopic bankart repair rehab protocol this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure. A biomechanical analysis of anchor placement for bankart. This protocol is not a substitute for a physiotherapists clinical reasoning during a patients postoperative healingprogress. Bankart repairanterior capsulorrhaphy rehabilitation. Do not separately report the debridement if the surgeon also repairs the debrided structures.
Posterior bankart repair rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Arthroscopic stabilisation bankart repair shoulderdoc by. We prefer to perform the surgery arthroscopically keyhole, but some surgeons prefer an open procedure. After the first day or two, as the pain lessens, you may decrease the frequency with which you take the medication. Bankart stabilization, ranging from 0% to 11%, establishing open stabilization as the gold standard for operative repair. Feb 02, 2015 arthroscopic transosseous bony bankart repair performed in a right shoulder in the lateral decubitus position. Arthroscopic bankart repair cayman orthopaedic group.
Arthroscopic anterior stabilization with or without bankart repair. Type 2 or 4 slap tear biceps anchor detached failure of at least 12 weeks of nonoperative treatment, including activity. Arthroscopic repair of posterior bony bankart lesion and subscapularis remplissage colten luedke, d. Arthroscopic stabilisation bankart repair this procedure involves repairing the over stretched or torn labrum and capsule deep within the shoulder joint.
Arthrex arthroscopic bankart repair with knotless remplissage. Arthroscopic stabilisation bankart repair shoulderdoc. Arthroscopic bankart repair protocol robert morgan md. Overview and recovery from a patients perspective doug letourneau is an avid basketball player in his free time. Oct 04, 2015 arthroscopic orthopedic surgical video of bankart stabilization of anteriorinferior glenohumeral ligament of the shoulder for recurrent shoulder dislocations from san francisco orthopaedic sports. 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.
However, it is critical to communicate with the surgeon in order to be aware. Pnf manual resistance endurance training restricted sport activities light swimming, half golf swings. Avoid any internal rotation of the glenohumeral joint. 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. No passive forceful stretching into external rotationextension for 3 months following an anterior repair and into internal rotation for a posterior repair. 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 arthroscopic treatment of anteriorglenohumeral instability is becoming. Arthroscopic bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging hillsachs lesion. The arthroscopic technique involves identifying and repairing all pathology that contribute to glenohumeral instability, i. Good posture is critical throughout the rehabilitation process to improve healing and decrease the risk of developing poor mechanics. This studys aim was to evaluate the performance of senior orthopedic residents during simulated arthroscopic anterior stabilization bankart repair. Immediately postoperatively, exercises must be modified so as not to place. Functional outcome of arthroscopic double row repair for bankart.
Petterson, phd anterior instability treated by arthroscopic surgery is a viable option to return the athlete. Ice 34 times per day as needed for 1st week then as needed thereafter. Pdf chapter05 arthroscopic bankart repair researchgate. Arthroscopic posterior bankart repair tmi sports medicine. For more educational videos from nyu langone orthopedics, visit. Continue to avoid heavy weight lifting or manual labor. To better understand what a bankart tear or lesion is, an overview of the shoulder is needed. Pdf on jan 1, 20, xinning li and others published chapter05 arthroscopic bankart repair find, read and cite all the research you need. We present a novel technique for safe establishment of the accessory posterior portal using a slotted cannula. Dr peter performs arthroscopic bankart repair surgery in claremont, murdoch, dunsborough, fremantle, cooloongup, northam and perth wa. Arthroscopic anterior bankart repair phase i immediate postoperative phase.
This document is intended for information purposes only and should not replace advice that your relevant health professional would give you. Arthroscopic bankart repair was first described in 1993, with its popularity rapidly increasing over the past several decades as arthroscopic instrumentation and techniques have improved. The pushlock anchor is designed for simple and secure arthroscopic glenohumeral joint instability repair. Arthroscopic bankart repair with suture anchors tips for success. Arthroscopic anterior capsulolabral reconstruction phase i. Guideline for arthroscopic anterior capsulolabral repair of the shoulder t.
Arthroscopic bankart repair in plano, frisco, mckinney and. Stay current when reporting shoulder procedures aapc. Arthroscopic bankart repair rehabilitation guidelines. Patients with additional surgery will progress at different rates. Bankart lesion, anterior shoulder instability, arthroscopic. The arthroscope uses a tiny camera to project a picture of your affected area onto a screen for your orthopedic surgeon to see. Matthew crawford this rehabilitation protocol has been developed for the patient following an arthroscopic bankart surgical procedure. Instructions for use documentation provided with individual components including. The knotless technique saves valuable time and eliminates the possibility of knot impingement. Also, do not reach your hand behind you as if to tuck in your shirt or to loop your belt.
This arthroscopic shoulder surgery is used to repair a detached labrum. Arthroscopic rotator cuff repair rehabilitation guidelines derek plausinis, masc, md, frcsc 0 to 6 weeks postop sling use. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus ball and the glenoid portion of the scapula socket. Never miscode bankart procedures again thanks to cpt 2004. Because the head of the humerus much larger than the. You will be sent home from the surgery center with prescriptions for pain medication. The bankart procedure is performed to increase anterior stability of the shoulder. Allow soft tissue healing diminish pain and inflammation initiate protected motion retard muscle atrophy. Ice 34 times per day as needed for 1 st week then as needed thereafter. Also, most payers consider the labrum to be one structure, and do not divide it into upper or lower portions for debridement. The repair is generally done through a minimally invasive approach called arthroscopic surgery. Bankart repair surgery is a minimally invasive surgery to repair instability and restore function of dislocated shoulders.
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. Summary table post op phasegoals range of motion therapeutic exercise precautions phase i 0 6 weeks after surgery. Flexion to 900 pendulumrope and pulley exercises isometrics. The critical point to to keep the shoulder muscles loose and relaxed. The american society of shoulder and elbow therapists consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. Take out of sling for arm exercises 24 times daily. Bankart repair can be performed surgically with an arthroscopic technique under general anaesthesia. Posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Click here to download pdf rehabilitation after arthroscopic posterior bankart repair. Jul 01, 2017 do not separately report the debridement if the surgeon also repairs the debrided structures.
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