Bankart Lesion: Causes Types, Symptoms, Diagnosis, and Treatment

Introduction

Shoulder injuries are common, and one particular condition that often arises is a Bankart lesion. Bankart lesion is a specific type of shoulder injury that commonly occurs as a result of recurrent shoulder dislocations. This lesion is named after a British orthopedic surgeon, Arthur Sydney Blundell Bankart. Injury to the labrum results in Bankart lesion. This article will explore the causes, symptoms, diagnosis, and treatment options for Bankart lesions.

What Is a Bankart Lesion?

A Bankart lesion refers to a tear or injury in the labrum, a ring of cartilage surrounding the shoulder joint. Bankart lesion is also called anteroinferior glenoid labrum lesion. Bankart lesion is often associated with Hill-Sachs lesion. Bankart lesions are a type of shoulder injury that commonly occurs as a result of anterior shoulder dislocation. This condition affects the labrum, a ring of fibrous cartilage that surrounds the shoulder socket, and can lead to chronic shoulder instability if left untreated. Bankart lesions can cause persistent shoulder instability and discomfort, affecting a person's daily activities and quality of life.

What Is the Anatomy of the Shoulder Joint?

To understand Bankart lesions, it is important to know the basic anatomy of the shoulder joint. The shoulder joint is a ball-and-socket joint where the rounded head of the humerus upper arm bone fits into a shallow socket called the glenoid fossa. The labrum surrounds the glenoid, deepening the socket, which is responsible for providing stability to the shoulder joint.

What Are the Causes of Bankart Lesion?

• Bankart lesion is common in sports persons who play volleyball, handball, tennis, and other sports that require overhead shoulder movements.

• Bankart lesions typically result from anterior shoulder dislocations, where the humerus is forced out of the glenoid socket towards the front of the body.

• This dislocation often occurs due to traumatic events, such as falls, sports injuries, overuse injuries, or car accidents.

• The forceful dislocation can lead to labral tears or detachments, resulting in a Bankart lesion.

What Are the Types of Bankart Lesions?

There are two types of Bankart lesions which include:

• Soft Bankart Lesion: It is the most common lesion where the labrum tears from the glenoid fossa and causes injury only to the soft tissues.

• Bony Bankart Lesion: In this type, the labrum tears and the bony part of the glenoid fossa break off, causing chronic instability of the shoulder and bone loss in the amount of the glenoid.

• In addition to this, a reverse Bankart lesion is said when the posterior shoulder dislocates.

What Is the Differential Diagnosis of Bankart Lesions?

Many lesions have similar symptoms to Bankart lesions which include:

• ALPSA (anterior labroligamentous periosteal sleeve avulsion).

• SLAP (superior labrum anterior posterior) lesion.

• Rotator cuff tears.

• Shoulder impingement.

• Perthes lesion.

• BHAGL (bony humerus avulsion of the gleniohumeral ligament).

• HAGL (humeral avulsion of the gleniohumeral ligament).

• GLAD (glenolabral articular disruption).

What Are the Symptoms of Bankart Lesion?

The primary symptom of a Bankart lesion is recurrent shoulder dislocation. Individuals with this condition often experience a sensation of the shoulder slipping out of place or a popping sound during certain movements. Other common symptoms include:

• People with Bankart lesions may experience persistent pain and tenderness in the front of the shoulder.

• People may experience a feeling of shoulder instability or looseness of the shoulder.

• People may experience recurrent shoulder dislocations or subluxations (partial dislocations).

• People may be affected with a limited range of motion in the affected shoulder.

• People may also experience difficulty in raising the shoulder overhead.

• People may also hear a popping, clicking, or catching sound during shoulder movement.

How Is Bankart Lesion Diagnosed?

Diagnosing Bankart lesions usually involve an effective evaluation by healthcare professionals. The diagnostic procedures may include the following:

• Medical History: Proper medical history, which includes the doctor's discussion about the onset of symptoms and any previous shoulder injuries.

• Physical Examination: The doctor will assess the range of motion, stability, and strength of the shoulder joint. They may perform specific tests, such as the apprehension test, to elicit symptoms of instability.

• Imaging Tests: X-rays can help rule out other causes of shoulder pain, while magnetic resonance imaging (MRI) and computed tomography (CT) scans provide detailed images of the shoulder joint and can reveal labral tears and associated injuries.

• Arthroscopy: In some cases, an arthroscopic procedure may be performed to directly visualize and diagnose the Bankart lesion. This minimally invasive technique involves inserting a small camera through tiny incisions to examine the shoulder joint.

How Is Bankart Lesion Treated?

The treatment of Bankart lesions depends on the severity of the injury and the patient's activity level, age, and other circumstances. The treatments may include

• Non-surgical Management: In some cases, conservative treatment such as rest, pain management with anti-inflammatory drugs, immobilization, physical therapy, and exercises that involve strengthening the shoulder muscles may be enough to eliminate the symptoms and improve shoulder stability.

• Surgical Intervention: When conservative measures fail or if the lesion is severe, surgical repair of the shoulder is often recommended by the doctors. Arthroscopic surgery is a common minimally invasive technique used to repair the torn labrum and retain the stability of the shoulder joint.

What Are the Rehabilitation and Recovery Measures for the Bankart Lesion?

• After surgical or non-surgical management, an effective rehabilitation program is essential to regain strength, stability, and range of motion in the shoulder.

• Physical therapy exercises, guided by a qualified physical therapist, help restore the shoulder's function and prevent future dislocations.

Prevention and Outlook for Bankart Lesions

While it is not always possible to prevent Bankart lesions caused by traumatic events, certain measures can minimize the risk of shoulder dislocations. These include maintaining shoulder strength and flexibility through regular exercise, using proper technique during sports activities, and avoiding situations that may lead to falls or direct trauma to the shoulder joint. With appropriate treatment and rehabilitation, the majority of individuals with Bankart lesions can regain shoulder stability and return to their normal activities.

Conclusion

Bankart lesions can significantly affect shoulder stability and function. Accurate diagnosis and appropriate treatment are essential for successful recovery. Bankart lesions may potentially cause long-term complications to the shoulders. Either through conservative treatment or surgical treatment, a tailored approach based on the patient's needs can help regain shoulder stability, reduce pain, and improve overall shoulder function. If a person suspects a Bankart lesion or experiences shoulder instability, reaching out to healthcare professionals for an accurate diagnosis and appropriate treatment plan may be beneficial.