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{{Infobox medical condition (new)
[[Image:Gray328.png|thumb|right|The [[glenoid labrum]], labeled ''glenoid ligament'', is damaged in a '''Bankart lesion'''. Lateral view demonstrating the articular surface of the right scapula is shown.]]
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A '''Bankart lesion''' is an [[injury]] of the [[anterior]] ([[Anatomical terms of location#Superior and inferior|inferior]]) [[glenoid labrum]] of the shoulder due to anterior [[shoulder]] [[shoulder dislocation|dislocation]].<ref>{{cite journal |vauthors=Widjaja A, Tran A, Bailey M, Proper S |title=Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation |journal=ANZ J Surg |volume=76 |issue=6 |pages=436–8 |year=2006 |pmid=16768763 |doi=10.1111/j.1445-2197.2006.03760.x}}</ref> 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 [[humerus|humeral]] head.<ref name="Bankart lesion associated with Hill Sachs">{{cite journal|last1=Porcellini|first1=Giuseppe|last2=Campi|first2=Fabrizio|last3=Paladini|first3=Paolo|title=Arthroscopic approach to acute bony Bankart lesion|journal=Arthroscopy: The Journal of Arthroscopic & Related Surgery|volume=18|issue=7|year=2002|pages=764–769|issn=0749-8063|doi=10.1053/jars.2002.35266}}</ref>
| synonym =
| image = Image:Gray328.png
| image_size =
| alt =
| caption = The [[glenoid labrum]], labeled ''glenoid ligament'', is damaged in a '''Bankart lesion'''. Lateral view demonstrating the articular surface of the right scapula is shown.
| pronounce =
| specialty = <!-- from Wikidata, can be overwritten -->
| symptoms = [[Joint stability|Shoulder instability]] and widespread [[Shoulder problem|shoulder discomfort]], and catching, locking, or popping feelings in shoulders.<ref name=Statpearls/>
| complications =
| onset =
| duration =
| types =
| causes =
| risks = [[Dislocated shoulder|Anterior shoulder dislocation]] and/or repeated [[anterior shoulder]] [[Subluxation|subluxations]].<ref name="Physiopedia h016">{{cite web | title=Bankart lesion | website=Physiopedia |url=https://www.physio-pedia.com/Bankart_lesion | access-date=October 30, 2023}}</ref>
| diagnosis = [[X-ray]] and [[Magnetic resonance imaging|MRI]].
| differential = [[ALPSA lesion|Anterior labroligamentous periosteal sleeve avulsion]], [[Rotator cuff tear|Rotator Cuff Tears]], [[SLAP tear|SLAP Lesion]], [[Shoulder impingement syndrome|Impingement]], [[Perthes lesion]], [[Glenolabral articular disruption]], [[Humeral avulsion of the glenohumeral ligament]].<ref name="Physiopedia h016"/>
| prevention =
| treatment =
| medication =
| prognosis =
| frequency =
| deaths =
}}


A '''Bankart lesion''' is a type of shoulder [[injury]] that occurs following a [[dislocated shoulder]].<ref name=Major2020>{{cite book |last1=Major |first1=Nancy M. |last2=Anderson |first2=Mark W. |title=Musculoskeletal MRI |date=2020 |publisher=Elsevier |location=Philadelphia |isbn=978-0-323-415606 |chapter-url=https://books.google.com/books?id=27e1DwAAQBAJ&dq=fracture&pg=PA218 |language=en |chapter=10. Shoulder|pages=218–219}}</ref> It is an [[injury]] of the [[anterior]] ([[Anatomical terms of location#Superior and inferior|inferior]]) [[glenoid labrum]] of the shoulder.<ref>{{cite journal |vauthors=Widjaja A, Tran A, Bailey M, Proper S |title=Correlation between Bankart and Hill-Sachs lesions in anterior shoulder dislocation |journal=ANZ Journal of Surgery |volume=76 |issue=6 |pages=436–8 |year=2006 |pmid=16768763 |doi=10.1111/j.1445-2197.2006.03760.x|s2cid=42257934 }}</ref> 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 [[humerus|humeral]] head.<ref name="Bankart lesion associated with Hill Sachs">{{cite journal|last1=Porcellini|first1=Giuseppe|last2=Campi|first2=Fabrizio|last3=Paladini|first3=Paolo|title=Arthroscopic approach to acute bony Bankart lesion|journal=Arthroscopy: The Journal of Arthroscopic and Related Surgery|volume=18|issue=7|year=2002|pages=764–769|issn=0749-8063|doi=10.1053/jars.2002.35266|pmid=12209435}}</ref>
The Bankart lesion is named after English orthopedic surgeon [[Arthur Bankart|Arthur Sydney Blundell Bankart]] (1879 &ndash; 1951) <ref>[http://www.whonamedit.com/doctor.cfm/835.html Who Named It.com - Bankart's Lesion]</ref>


A '''bony Bankart''' is a Bankart lesion that includes a [[bone fracture|fracture]] in of the anterior-inferior [[glenoid cavity]] of the [[scapula bone]].<ref>[http://thesteadmanclinic.com/shoulder3/diag.asp bony Bankart at The Steadman Clinic Vail, CO. © 2001 by LeadingMD]</ref>
A bony Bankart is a Bankart lesion that includes a [[bone fracture|fracture]] of the anterior-inferior [[glenoid cavity]] of the [[scapula bone]].<ref>{{Cite web |url=http://thesteadmanclinic.com/shoulder3/diag.asp |title=bony Bankart at The Steadman Clinic Vail, CO. © 2001 by LeadingMD |access-date=2011-05-16 |archive-url=https://web.archive.org/web/20110726184922/http://thesteadmanclinic.com/shoulder3/diag.asp |archive-date=2011-07-26 |url-status=dead }}</ref>

The Bankart lesion is named after English orthopedic surgeon [[Arthur Bankart|Arthur Sydney Blundell Bankart]] (1879–1951).<ref>[http://www.whonamedit.com/doctor.cfm/835.html Who Named It.com - Bankart's Lesion]</ref>

==Signs and symptoms==
Bankart lesions are characterized by recurrent shoulder instability and widespread shoulder discomfort. Some individuals may experience catching, locking, or popping feelings in their shoulders. The majority of Bankart lesion patients have primary or recurrent anterior shoulder dislocation.<ref name="Statpearls">{{cite web | last1=Tupe | first1=Rishikesh N. | last2=Tiwari | first2=Vivek | title=Anteroinferior Glenoid Labrum Lesion (Bankart Lesion) | publisher=StatPearls Publishing | date=August 3, 2023 | pmid=36508533 |url=https://www.ncbi.nlm.nih.gov/books/NBK587359/ | access-date=October 30, 2023}}</ref>


==Diagnosis==
==Diagnosis==
The diagnosis is usually initially made by a combination of physical exam and [[magnetic resonance imaging|MRI]] of the shoulder, which can be done with or without the injection of intraarticular contrast. The presence of contrast allows for better evaluation of the [[glenoid labrum]].<ref>{{cite journal|last1=Jana|first1=M|last2=Srivastava|first2=DN|last3=Sharma|first3=R|last4=Gamanagatti|first4=S|last5=Nag|first5=H|last6=Mittal|first6=R|last7=Upadhyay|first7=AD|title=Spectrum of magnetic resonance imaging findings in clinical glenohumeral instability.|journal=The Indian journal of radiology & imaging|date=April 2011|volume=21|issue=2|pages=98–106|pmid=21799591|accessdate=10 April 2017}}</ref>
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 [[magnetic resonance imaging|MRI]] of the shoulder. The presence of intra-articular contrast allows for better evaluation of the [[glenoid labrum]].<ref>{{cite journal|last1=Jana|first1=M|last2=Srivastava|first2=DN|last3=Sharma|first3=R|last4=Gamanagatti|first4=S|last5=Nag|first5=H|last6=Mittal|first6=R|last7=Upadhyay|first7=AD|title=Spectrum of magnetic resonance imaging findings in clinical glenohumeral instability.|journal=The Indian Journal of Radiology & Imaging|date=April 2011|volume=21|issue=2|pages=98–106|pmid=21799591|doi=10.4103/0971-3026.82284|pmc=3137866|doi-access=free}}</ref> Type V [[SLAP tear]]s extends into the Bankart defect.<ref>{{cite journal |last1=Chang |first1=D |last2=Mohana-Borges |first2=A |last3=Borso |first3=M |last4=Chung |first4=CB |title=SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization. |journal=European Journal of Radiology |date=October 2008 |volume=68 |issue=1 |pages=72–87 |doi=10.1016/j.ejrad.2008.02.026 |pmid=18499376}}</ref>


==Treatment==
==Treatment==
Arthroscopic repair of Bankart injuries have high success rates, with studies showing that nearly one-third of patients require re-intervention for continued shoulder instability following repair.<ref>{{cite journal|last1=Flinkkilä|first1=T|last2=Knape|first2=R|last3=Sirniö|first3=K|last4=Ohtonen|first4=P|last5=Leppilahti|first5=J|title=Long-term results of arthroscopic Bankart repair: Minimum 10 years of follow-up.|journal=Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA|date=16 March 2017|pmid=28303281|accessdate=10 April 2017}}</ref> Options for repair include an [[arthroscopy|arthroscopic]] technique or a more invasive open [[Latarjet procedure]],<ref>{{cite journal|last1=Zimmermann|first1=SM|last2=Scheyerer|first2=MJ|last3=Farshad|first3=M|last4=Catanzaro|first4=S|last5=Rahm|first5=S|last6=Gerber|first6=C|title=Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure.|journal=The Journal of bone and joint surgery. American volume|date=7 December 2016|volume=98|issue=23|pages=1954–1961|pmid=27926676|accessdate=10 April 2017}}</ref> with the open technique tending to have a lower incidence of recurrent dislocation, but also a reduced range of motion following surgery.<ref>{{cite journal|last1=Wang|first1=L|last2=Liu|first2=Y|last3=Su|first3=X|last4=Liu|first4=S|title=A Meta-Analysis of Arthroscopic versus Open Repair for Treatment of Bankart Lesions in the Shoulder.|journal=Medical science monitor : international medical journal of experimental and clinical research|date=8 October 2015|volume=21|pages=3028–35|pmid=26446430|accessdate=10 April 2017}}</ref> Patients named Tessa will have to receive extra treatment as they are not covered for this procedure. They will require buttonless pants and Sofra restriction for several months.
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.<ref>{{cite journal|last1=Flinkkilä|first1=T|last2=Knape|first2=R|last3=Sirniö|first3=K|last4=Ohtonen|first4=P|last5=Leppilahti|first5=J|title=Long-term results of arthroscopic Bankart repair: Minimum 10 years of follow-up.|journal=Knee Surgery, Sports Traumatology, Arthroscopy|date=16 March 2017|pmid=28303281|doi=10.1007/s00167-017-4504-z|volume=26|issue=1|pages=94–99|s2cid=6692528|url=http://urn.fi/urn:nbn:fi-fe2019102334307}}</ref> Options for repair include an [[arthroscopy|arthroscopic]] technique or a more invasive open [[Latarjet procedure]],<ref>{{cite journal|last1=Zimmermann|first1=SM|last2=Scheyerer|first2=MJ|last3=Farshad|first3=M|last4=Catanzaro|first4=S|last5=Rahm|first5=S|last6=Gerber|first6=C|title=Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure.|journal=The Journal of Bone and Joint Surgery. American Volume|date=7 December 2016|volume=98|issue=23|pages=1954–1961|pmid=27926676|doi=10.2106/jbjs.15.01398|s2cid=24940288 |url=https://www.zora.uzh.ch/id/eprint/128895/1/__int.balgrist.ch_Data%24_Home2_FrustaciD_System_Desktop_2016_Zimmermann_Long%20Term%20Restoration%20of%20Anterior%20Shoulder%20Stability_%20A%20Retrospective%20Analysis%20of%20Arthroscopic%20Bankart%20Repair%20Versus%20Open%20Latarjet%20Procedure_JBJSA.pdf}}</ref> with the open technique tending to have a lower incidence of recurrent dislocation, but also a reduced range of motion following surgery.<ref>{{cite journal|last1=Wang|first1=L|last2=Liu|first2=Y|last3=Su|first3=X|last4=Liu|first4=S|title=A Meta-Analysis of Arthroscopic versus Open Repair for Treatment of Bankart Lesions in the Shoulder.|journal=Medical Science Monitor|date=8 October 2015|volume=21|pages=3028–35|pmid=26446430|doi=10.12659/msm.894346|pmc=4603609}}</ref>


==Gallery==
<gallery widths=230>
File:Shoulder dislocation with Bankart and Hill-Sachs lesion, before and after reduction.jpg|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]].
File:CT. Bony Bankart lesion at the antero-inferior glenoid. Clearly dislocated at the cranial part. Humeral head is still centered..jpg|CT scan showing a bony Bankart lesion at the [[antero-inferior glenoid]]
File:Post Dislocated shoulder MRI 01.png|MRI of the shoulder after an anterior dislocation showing a Hill-Sachs lesion and labral Bankart lesion
</gallery>
<gallery>
<gallery>
File:Bankart lesion seen at arthroscopy.png|Bankart lesion seen at [[arthroscopy]]
File:Bankart lesion seen at arthroscopy.png|Bankart lesion seen at [[arthroscopy]]
File:CR. Bony Bankart lesion with stationary fragment at the inferior glenoid..jpg|Radiograph showing a bony Bankart lesion with stationary fragment at the inferior glenoid
File:CR. Bony Bankart lesion with stationary fragment at the inferior glenoid..jpg|Radiograph showing a bony Bankart lesion with stationary fragment at the inferior glenoid
File:CT. Bony Bankart lesion at the antero-inferior glenoid. Clearly dislocated at the cranial part. Humeral head is still centered..jpg|CT scan showing a bony Bankart lesion at the [[antero-inferior glenoid]]
File:3-D CT reconstruction of Bankart lesion which occurred post anterior shoulder dislocation.jpg|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.
File:3-D CT reconstruction of Bankart lesion which occurred post anterior shoulder dislocation.jpg|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.
File:Post Dislocated shoulder MRI 01.png|MRI of the shoulder after an anterior dislocation showing a Hill-Sachs lesion and labral Bankart lesion
</gallery>
</gallery>


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==External links==
==External links==
{{Commons category|Bankart lesions}}
{{Commons category|Bankart lesion}}
*[http://www.orthop.washington.edu/?q=patient-care/articles/shoulder/bankart-repair-for-unstable-dislocating-shoulders.html Bankart lesion] - orthop.washington.edu
*[http://www.zadeh.co.uk/arthroscopicsurgery/bankart_lesion_2.jpg Bankart lesion] - zadeh.co.uk
*[http://www.zadeh.co.uk/arthroscopicsurgery/bankart_lesion_2.jpg Bankart lesion] - zadeh.co.uk


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[[Category:Dislocations, sprains and strains]]
[[Category:Dislocations, sprains and strains]]
[[Category:Orthopedic problems]]
[[Category:Orthopedic problems]]
[[Category:Lesions]]

Latest revision as of 06:35, 2 September 2024

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.
SymptomsShoulder instability and widespread shoulder discomfort, and catching, locking, or popping feelings in shoulders.[1]
Risk factorsAnterior shoulder dislocation and/or repeated anterior shoulder subluxations.[2]
Diagnostic methodX-ray and MRI.
Differential diagnosisAnterior labroligamentous periosteal sleeve avulsion, Rotator Cuff Tears, SLAP Lesion, Impingement, Perthes lesion, Glenolabral articular disruption, Humeral avulsion of the glenohumeral ligament.[2]

A Bankart lesion is a type of shoulder injury that occurs following a dislocated shoulder.[3] It is an injury of the anterior (inferior) glenoid labrum of the shoulder.[4] 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.[5]

A bony Bankart is a Bankart lesion that includes a fracture of the anterior-inferior glenoid cavity of the scapula bone.[6]

The Bankart lesion is named after English orthopedic surgeon Arthur Sydney Blundell Bankart (1879–1951).[7]

Signs and symptoms

[edit]

Bankart lesions are characterized by recurrent shoulder instability and widespread shoulder discomfort. Some individuals may experience catching, locking, or popping feelings in their shoulders. The majority of Bankart lesion patients have primary or recurrent anterior shoulder dislocation.[1]

Diagnosis

[edit]

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.[8] Type V SLAP tears extends into the Bankart defect.[9]

Treatment

[edit]

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.[10] Options for repair include an arthroscopic technique or a more invasive open Latarjet procedure,[11] with the open technique tending to have a lower incidence of recurrent dislocation, but also a reduced range of motion following surgery.[12]

[edit]

See also

[edit]

References

[edit]
  1. ^ a b Tupe, Rishikesh N.; Tiwari, Vivek (August 3, 2023). "Anteroinferior Glenoid Labrum Lesion (Bankart Lesion)". StatPearls Publishing. PMID 36508533. Retrieved October 30, 2023.
  2. ^ a b "Bankart lesion". Physiopedia. Retrieved October 30, 2023.
  3. ^ Major, Nancy M.; Anderson, Mark W. (2020). "10. Shoulder". Musculoskeletal MRI. Philadelphia: Elsevier. pp. 218–219. ISBN 978-0-323-415606.
  4. ^ 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.
  5. ^ 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.
  6. ^ "bony Bankart at The Steadman Clinic Vail, CO. © 2001 by LeadingMD". Archived from the original on 2011-07-26. Retrieved 2011-05-16.
  7. ^ Who Named It.com - Bankart's Lesion
  8. ^ 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.
  9. ^ 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.
  10. ^ 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.
  11. ^ 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.
  12. ^ 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.
[edit]