Arthroscopic Bankart repair · Dr Joe Coory

Type: Keyhole (arthroscopic) stabilisation
Anaesthesia: General + interscalene block
Day surgery / 1 night: Often day surgery
Sling: 4 weeks
Return to contact sport: 4–6 months
Re-dislocation rate: 5–15% (depending on bone loss)

What it is.

Arthroscopic Bankart repair is a keyhole stabilisation operation in which the torn labrum at the front of the glenoid socket is sutured back to bone using small suture anchors. It is the workhorse operation for shoulder instability in patients with minimal glenoid bone loss.

How it is performed.

Performed under general anaesthesia with a regional block. Three to four 5 mm portals are used around the shoulder. The arthroscope is introduced and the joint is examined for any associated pathology. The torn anterior labrum is identified, gently mobilised back to its native position, and the front rim of the glenoid is prepared. Small suture anchors are placed into the bone, and the labrum is sutured back to restore the anterior labral bumper. The capsule is tensioned as required. A remplissage — a separate repair to fill the impression fracture at the back of the humeral head (Hill-Sachs lesion) — is added in selected cases.

Patient selection.

Arthroscopic Bankart is the right operation in patients with:

Recurrent anterior shoulder instability
Minimal glenoid bone loss (typically less than 15% on CT)
An "off-track" engaging Hill-Sachs lesion that can be addressed with a remplissage
Activity profile compatible with a long return-to-sport timeline

Patients with significant glenoid bone loss are better served by a Latarjet procedure, in which a bone block is transferred to the front of the glenoid.

Recovery.

Week 0–4

Sling worn continuously.
Passive range of motion under physiotherapist.
External rotation is restricted to protect the repair.

Week 4–12

Sling discontinued at 4 weeks.
Active-assisted range of motion progresses to active range.
Driving resumed at 4–6 weeks.

Month 3–6

Strengthening commences.
Return to non-contact sport from 3 months.
Return to contact sport at 4–6 months once strength and confidence are restored.

Rehabilitation protocol.

A written copy of this protocol is provided to your physiotherapist on the day of surgery. The timeline below covers both anterior and posterior stabilisation — your surgeon will confirm which pathway applies.

Anterior stabilisation (Bankart repair)

Phase 1 — weeks 0–4 (protection)

Sling at all times except during prescribed exercises.
Passive and active-assisted range of motion: forward flexion to 90 degrees, abduction to 45 degrees, external rotation to 30 degrees, internal rotation to stomach level.
Isometric exercises for rotator cuff and scapula stabilisers.
Active range of motion for elbow, wrist and hand.

Phase 2 — weeks 4–6 (early mobilisation)

Discontinue sling.
Increase range of motion toward full.
Theraband resistance exercises.
Scapula stabilising programme.

Phase 3 — weeks 6–12 (strengthening)

Full active range of motion expected.
Light dumbbell strengthening (1–5 lbs) progressing gradually.
Proprioceptive and functional rehabilitation.

Phase 4 — months 3–6 (return to sport)

Sport-specific training and conditioning.
Throwing programme from 4.5 months if applicable.
Full return to contact sport at 6 months.

Posterior stabilisation

Phase 1 — weeks 0–6 (protection)

Sling in flexion, abduction and neutral rotation.
No range of motion for the first 3 weeks.
Weeks 3–6: passive range of motion — forward flexion to 90 degrees, abduction to 90 degrees, internal rotation to 45 degrees.

Phase 2 — weeks 6–12 (mobilisation)

Sling removed at week 8.
Active-assisted and active range of motion targets: 135 degrees forward flexion, 120 degrees abduction, full external rotation.
Resistive exercises from week 8 — below the horizontal plane only.

Phase 3 — weeks 12–16 (strengthening)

Full active range of motion expected.
Glenohumeral stabilisation exercises.
Eccentric strengthening programme.

Phase 4 — months 4–6 (return to sport)

Sport-specific training and conditioning.
Full return to contact sport at 6 months.

View the recovery roadmap for the full rehabilitation journey, or visit For Physiotherapists for protocol requests.

Frequently asked questions.

Bankart or Latarjet — how do you decide?

The decision is based on the 3D CT assessment of glenoid bone loss. With minimal bone loss, arthroscopic Bankart is reliable. With significant bone loss (typically more than 15–20%), Latarjet has a lower failure rate.

What is a remplissage?

A small additional repair that fills the impression fracture at the back of the humeral head (the Hill-Sachs lesion). It prevents that defect from “hooking” on the front of the glenoid during external rotation and adds protection to the Bankart repair.

How long am I in the sling?

Four weeks. Sleeping in the sling is comfortable for most patients during the first 1–2 weeks; many transition to a pillow setup after that.

When can I return to contact sport?

4–6 months. The decision is based on strength, range of motion and functional confidence rather than the calendar alone.

Will my shoulder dislocate again?

Re-dislocation rates depend most strongly on residual bone loss and the demands of your sport. With minimal bone loss and modern technique, reported rates are between 5% and 15%.

References.

Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs. Arthroscopy. 2000;16(7):677–694.
Di Giacomo G, et al. Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from “engaging/non-engaging” to “on-track/off-track”. Arthroscopy. 2014;30(1):90–98.

Arthroscopic Bankart repair.