What it is
Bankart repair and related stabilisation procedures reattach the torn labrum and tighten the capsule after anterior shoulder dislocation. The aim is to restore stability and confidence in high-risk positions.
Procedures are usually arthroscopic. Bone procedures, such as the Latarjet (described in detail below), are used when bone loss is present. Rehabilitation is essential for durable results.
What happens when it occurs
Anchors and sutures reattach the labrum and shift the capsule. Early phases protect the repair. Control and strength are rebuilt. Exposure to external rotation and abduction is graduated before return to contact or overhead sport.
Common causes and risk factors
- Tackles and falls with the arm out to the side
- Previous dislocations and poor control
- Generalised laxity and younger age at first event
- Bony defects of the glenoid or the humeral head
Who is most affected
Teens and young adults in contact and overhead sports. Men present more often after traumatic events.
Typical symptoms pre op
- Recurrent giving way and apprehension in external rotation and abduction
- Pain with tackles or overhead positions
- Loss of confidence
When to seek care
After a first dislocation or recurrent events, early planning reduces the risk of recurrence.
How we diagnose
History, apprehension and relocation tests, and imaging. MRI arthrogram assesses labrum and capsule; CT evaluates bone loss when needed.
Management
- Sling protection and a staged range of motion
- Scapular control and rotator cuff activation
- Progressive external rotation exposure and strength
- Contact and overhead preparation with criteria-based testing
Rehabilitation milestones
Phase 1 weeks 0 to 4: sling, protected passive range, isometrics.
Phase 2 weeks 4 to 8: active range, early strength in safe arcs.
Phase 3 months 2 to 4: progressive external rotation, closed then open chain loading, proprioception.
Phase 4 months 4 to 6: contact skills and overhead work, return to training after testing.
Readiness to progress
- No apprehension in the position of risk
- External rotation and abduction range restored without pain
- Strength within 90 per cent and hop style upper limb tests passed
Surgery – Laterjet Procedure
Latarjet surgery is a procedure that treats recurrent anterior shoulder instability and bone loss in the shoulder socket by transferring a bone fragment from the shoulder blade (coracoid process) with its attached tendons to the front rim of the shoulder socket. This operation is performed to stabilise a shoulder where bone damage has occurred after traumatic shoulder dislocation(s).
It is performed under general anaesthesia and nerve block as a day case, or with an overnight stay. An incision is made over the front of your shoulder. Your coracoid process is carefully cut from your shoulder blade. A split through the muscle and capsule allows access to your shoulder joint. Your area of glenoid bone loss is prepared for the bone graft. Your coracoid graft and its attached tendons are passed through the muscle split and screwed into place using two screws into your shoulder blade. This restores bone loss and provides a muscle “dynamic” sling effect to prevent further dislocations, making it a highly effective solution for athletes, especially those involved in contact sports. Your wound is closed with dissolvable stitches.
Indication
- Instability with glenoid bone loss
- Combinations of glenoid and humeral bone loss
- Complex soft-tissue injury
- Revision of a Bankart or SLAP repair
- Patients engaged in high-risk sports (such as climbing and rugby) or occupations (like carpentry), or those with a high risk of recurrence due to the intensity and nature of their activity (such as throwers), are ideal candidates for the Latarjet procedure.
Long-term care
- Maintain control and strength, especially in the preseason
- Use graded contact exposure
- Manage training spikes in overhead work
Australia snapshot
- Frequent in rugby league, rugby union, AFL, and court sports
- Recurrence risk is higher in younger contact athletes
- Public and private centres provide arthroscopic stabilisation and rehabilitation
Latest insights
Stability is a skill built on a solid foundation of structure. Repair plus training produces durable results.
External rotation control is the gateway to contact and overhead return.
