Bankart Surgery: Duration, Influencing Factors, and Recovery Timeline

How long is Bankart surgery?

Bankart surgery, a procedure to repair a torn labrum in the shoulder, typically involves an operative time ranging from 60 to 90 minutes for the repair itself. However, the total time spent in the operating room suite, encompassing pre-operative preparation, anesthesia induction, the surgery, and immediate post-anesthesia recovery, usually extends to 2 to 3 hours.

Understanding Bankart Lesions and Surgery

A Bankart lesion refers to a specific type of injury to the shoulder's glenoid labrum, a ring of cartilage that deepens the shoulder socket (glenoid) and helps stabilize the shoulder joint. This lesion commonly occurs when the shoulder dislocates, particularly anteriorly (forward), tearing the inferior (lower) portion of the labrum from the glenoid bone. This detachment compromises the stability of the shoulder joint, leading to recurrent dislocations or a persistent feeling of instability.

Bankart surgery is primarily performed to reattach the torn labrum to the glenoid bone, thereby restoring the anatomical integrity and stability of the shoulder joint. The goal is to prevent future dislocations and improve the shoulder's function and strength.

Factors Influencing Surgical Duration

While an estimated timeframe can be provided, the actual duration of Bankart surgery can vary based on several critical factors:

• Type of Procedure:
  • Arthroscopic Bankart Repair: This is the most common approach. It's minimally invasive, utilizing small incisions, a camera (arthroscope), and specialized instruments. It generally takes less time than open surgery and is associated with faster initial recovery.
  • Open Bankart Repair: Less common now, this involves a larger incision. It might be chosen for more complex cases, revisions, or when significant bone loss is present. Open procedures typically take longer due to the increased tissue dissection required.
• Complexity of the Lesion:
  • Size and Extent of the Tear: Larger or more extensive labral tears may require more sutures and more time to repair.
  • Associated Injuries: The presence of concomitant injuries, such as a Hill-Sachs lesion (a compression fracture on the humeral head), rotator cuff tears, or significant bone loss from the glenoid (bony Bankart lesion), can significantly increase surgical time as these may require additional repair procedures (e.g., Remplissage procedure for Hill-Sachs, Latarjet procedure for bony loss).
• Surgeon's Experience and Technique: A highly experienced surgeon may perform the procedure more efficiently. Surgical technique, including the number and type of anchors used, also plays a role.
• Anesthesia Induction and Recovery: The time spent administering anesthesia (general or regional) and the initial post-operative monitoring in the Post-Anesthesia Care Unit (PACU) are part of the overall time spent within the surgical facility, though not directly part of the "surgical time" itself.
• Operating Room Setup: The time required for sterile draping, equipment setup, and patient positioning before the first incision contributes to the total room time.

Typical Surgical Timeline

Understanding the overall process can help manage expectations:

• Pre-Operative Preparation (30-60 minutes): This includes patient check-in, review of medical history, IV line placement, meeting the surgical team (surgeon, anesthesiologist, nurses), and marking the surgical site.
• Surgical Procedure (60-90 minutes): This is the actual time the surgeon is performing the repair. For an arthroscopic Bankart repair, the process involves:
  • Creating small incisions (portals).
  • Inserting the arthroscope to visualize the joint.
  • Debriding any damaged tissue.
  • Preparing the glenoid bone.
  • Using suture anchors to reattach the torn labrum to the glenoid.
  • Closing the incisions.
• Post-Anesthesia Care Unit (PACU) (1-2 hours): After the surgery, the patient is transferred to the PACU for close monitoring as they recover from anesthesia. Vital signs are observed, pain is managed, and any immediate post-operative concerns are addressed before discharge or transfer to a hospital room.

What to Expect Post-Surgery

Immediately following Bankart surgery, the shoulder will be immobilized in a sling, often for 4-6 weeks, to protect the repair. Pain management will be a priority.

Rehabilitation is a critical component of successful recovery and often takes several months. It is typically divided into phases:

• Phase 1 (Protection): Focus on protecting the repair, reducing pain and swelling, and gentle passive range of motion.
• Phase 2 (Early Motion): Gradually increasing active range of motion, light strengthening exercises.
• Phase 3 (Strength and Endurance): Progressive strengthening, neuromuscular control, and sport-specific drills.
• Phase 4 (Return to Activity): Gradual return to full activities, including sports, typically 6-9 months post-op, depending on the individual and the demands of their activity.

Importance of Comprehensive Rehabilitation

While the surgical repair provides the anatomical foundation for stability, the success of Bankart surgery heavily relies on a diligent and structured physical therapy program. Rehabilitation aims to:

• Restore full, pain-free range of motion.
• Rebuild strength in the shoulder and surrounding musculature.
• Improve proprioception and neuromuscular control.
• Gradually return the individual to their desired functional activities, including sports, with reduced risk of re-injury.

Adherence to the prescribed rehabilitation protocol, guided by a qualified physical therapist, is paramount to achieving optimal long-term outcomes and preventing recurrent instability.

Conclusion

Bankart surgery is a highly effective procedure for restoring shoulder stability after a labral tear. While the direct surgical repair typically lasts 60 to 90 minutes, the overall time spent in the surgical facility, including preparation and recovery, generally ranges from 2 to 3 hours. The duration can fluctuate based on the specific surgical approach, the complexity of the injury, and the surgeon's expertise. Crucially, the surgical phase is just the beginning of the journey, with a comprehensive and consistent rehabilitation program being essential for a successful return to full shoulder function and activity.