Overview
When your shoulder dislocates forward, the ball (humeral head) slips past the front of the socket. On its way out, it tears a piece of the cartilage rim. That rim is called the labrum. It is a firm cartilage gasket that deepens the shallow socket. It also anchors the main ligaments that hold the joint steady. The tear at the front-lower part of the rim is called a Bankart lesion. It occurs in the vast majority of first-time dislocations caused by injury.
Once the labrum is torn off the rim, the front of the shoulder loses its main soft-tissue restraint. The risk of dislocating again is tied to your age at the first dislocation. A patient under 20 has roughly an 80% chance of dislocating again without surgery. The risk drops with age but remains significant through the 30s. Each repeat dislocation chips more bone off the front of the socket and off the back of the ball. Each one makes the instability harder to fix.
Bankart repair reattaches the torn labrum and ligaments to the rim of the socket using small bone anchors. That restores the depth and tension of the socket. In most cases the surgery is done through small camera incisions (arthroscopy), which shortens recovery compared to open surgery. When there is significant bone loss on either the socket or the ball, a larger rebuild that uses bone graft may be needed instead of a soft-tissue repair alone.
How the Procedure Works
The repair is done through small puncture holes with a camera. The first step is freeing the torn labrum completely off the bone, where it has been sitting scarred and out of place. If it is not fully released, it can heal in the wrong spot. That is the single most common reason these repairs fail. The front rim of the socket is then prepared down to bleeding bone so the labrum has something to heal into.
Your surgeon places small anchors (typically three) into the rim, working from the bottom up. Each anchor carries stitches that pull the labrum back to its original position. The stitches also tighten the front of the joint capsule, removing the looseness that lets the ball slip forward. Before closing, your surgeon moves the arm into the position that originally caused the dislocation. That confirms the joint is stable without being too tight.
When to Consider Bankart Repair
Bankart repair comes into play when your symptoms, imaging, and the result of non-surgical care all point to surgery as the next step. The typical patient profile:
First-time or recurrent dislocation
A young, active patient with one or more forward dislocations, often in a contact or overhead sport.
High-risk population
Contact athletes and active military members, where the risk of repeat dislocation without surgery is very high.
Limited bone loss on the socket rim
Bone loss on the socket rim small enough that a soft-tissue repair can still hold. When too much bone is gone, a bone-grafting procedure (the Latarjet) is needed instead.
Conditions This Treats
Risks & Why We Still Recommend It
Every operation carries risk. This procedure is offered because the condition, when left untreated, can cause repeated forward dislocations that damage the labrum, the socket bone, and the cartilage and make future repair harder. The decision to proceed weighs the risks of surgery against the limitations the condition places on daily function. Surgery does not remove risk; it addresses a problem that is otherwise progressive. Whether it is appropriate is determined for each patient in consultation with the surgeon.
The risks we discuss with you before Bankart repair include:
- bleeding and infection
- anesthesia risk
- stiffness, especially loss of the ability to rotate the arm outward
- the shoulder coming loose again, especially in contact athletes or when socket bone loss is significant
- irritation from the suture anchors
- short-lived nerve irritation from arm positioning or the nerve block
Surgery makes sense when you have confirmed forward shoulder instability with a clear Bankart lesion, and enough bone left on the front rim of the socket to anchor a soft-tissue repair. If that picture does not fit you, we do not offer this operation.
Frequently Asked
questions we hear in clinicIf I skip surgery, will my shoulder dislocate again?
The risk is tied to your age at the first dislocation. A patient under 20 has roughly an 80% chance of dislocating again without surgery. The risk drops with age but remains significant through the 30s, and each repeat dislocation chips more bone off the socket and the ball, making the instability harder to fix.
Is this open surgery?
In most cases the repair is done through small camera incisions (arthroscopy), which shortens recovery compared to open surgery.
What holds the repair in place?
Small bone anchors, typically three, are placed into the rim of the socket. Each anchor carries stitches that pull the labrum back to its original position and tighten the front of the joint capsule.
Why do some of these repairs fail?
The single most common reason is a labrum that was not fully released from where it healed out of place, so it heals in the wrong spot again. That is why the first step is freeing the torn labrum completely off the bone and preparing the rim down to bleeding bone, and why your surgeon tests the shoulder in the position that originally caused the dislocation before closing.
What if I have already lost bone from repeated dislocations?
A soft-tissue repair needs enough bone left on the front rim of the socket to hold. When bone loss on the socket or the ball is significant, a bone-grafting procedure like the Latarjet is needed instead.
Further Reading
External patient-education references and related OSI pages for additional background:
