Current techniques in arthroscopic Bankart repair

Background: Since its initial description, Bankart repair techniques have transitioned from open procedures to arthroscopic stabilization, which is now the preferred intervention for over 90% of surgeons. While open techniques were historically the gold standard, concerns regarding postoperative external rotation restrictions and secondary osteoarthritis have led to the increased adoption of arthroscopic methods. Modern advancements in suture anchor technology and instrumentation have improved success rates, making arthroscopic outcomes comparable to open repair.

Objective: This article details a standardized arthroscopic Bankart repair technique using suture anchors, emphasizing patient selection, portal placement, and specific intra-operative maneuvers to optimize clinical outcomes.

Key Points: Successful stabilization requires a comprehensive preoperative work-up, including 3D-CT to quantify glenoid bone loss and Hill-Sachs lesions. The procedure is performed in the lateral decubitus position using three portals. Critical technical steps include the complete mobilization of the capsulolabral complex from the glenoid neck until subscapularis fibers are visible and the preparation of the glenoid rim to facilitate biological healing. The authors utilize 1.8mm all-suture anchors, typically placing three anchors starting from the 5:30 position. Labral tension is maintained during the application of sliding Duncan loop knots to ensure anatomical restoration of the native joint stability.

Conclusion: Arthroscopic Bankart repair is an effective treatment for anterior shoulder instability in patients without significant bone loss. Success depends on meticulous labral mobilization and anatomical fixation, which restores the native stabilizers of the glenohumeral joint.