Arthroscopic Labrum(Bankart) Repair

The Goal

Dr. Kevin Wall provides specialized, fellowship-trained surgical treatment for Arthroscopic Labrum Repair to restore function and relieve pain for patients in Richmond, VA, and the surrounding Central Virginia communities. The goal of this procedure is to restore stability to a shoulder that has suffered a labral tear, usually from a traumatic dislocation or subluxation. The labrum is a specialized ring of fibrocartilage that deepens the glenoid (the shoulder socket); when it is torn (a Bankart lesion), the shoulder loses its natural "bumper," making it prone to repeated dislocations. This is when the humeral head (the ball) is able to translate out of the socket. For our athletes and activite individuals, the objective is to reattach the labrum securely to the bone, tension the surrounding capsule, and restore the joint's bumper effect, allowing for a confident return to collision and overhead sports and recreational activities. A careful evaluation using MRI and sometimes CT is necessary to ensure there is no, or minimal, bone loss on the glenoid, which may require a bone-restoring procedure such as a Latarjet or distal tibial allograft reconstruction.

This page is designed to educate you specifically about this procedure. Additional information that generally applies to most of Dr. Wall’s surgeries can be found on these pages:

The Procedure

  • The Approach: Performed entirely arthroscopically (minimally invasive) using 2–3 small "keyhole" incisions.

  • Diagnostic Assessment: Dr. Wall evaluates the quality of the labral tissue and the extent of any associated "Hill-Sachs" lesion (a dent in the ball of the shoulder).

  • Tissue Mobilization: The torn labrum is carefully freed from its scarred position on the neck of the glenoid to ensure it can be brought back to its proper anatomical location on the joint rim.

  • Anatomic Fixation: Small suture anchors are placed into the glenoid bone. Their high-strength sutures are then passed through the labrum and capsule, bringing the tissue back into position to recreate the natural bumper.

  • Remplissage (Optional): If a large Hill-Sachs defect is present, Dr. Wall may also perform a "remplissage," where the infraspinatus tendon is tucked into the defect to prevent it from "catching" on the rim of the socket.

Post-Op Protocol

  • Immobilization (Phase 1: 0–4 weeks): A sling with a pillow must be worn at all times, including during sleep, to protect the repair. You may remove it for hygiene, very gentle pendulums, and elbow/wrist motion. No lifting, pushing, pulling, or overhead activities are permitted.

  • Formal PT Start: Professional physical therapy begins at Post-Op Week 4 (for anterior repairs) or Week 2 (for posterior repairs).

  • Phase 2 (4–6 weeks): Continue sling use, but begin weaning if anterior repair. Therapy focuses on progressive passive and active-assisted range of motion (PROM/AAROM).

  • Phase 3 (6–8 weeks): The sling is discontinued. You begin active range of motion (AROM). You may now lift up to 10 pounds.

  • Phase 4 (8–16 weeks): Goal of achieving full motion. Progressive strengthening begins with resistance bands at Week 12.

  • Full Recovery (16 weeks+): Strengthening progresses to weights. A return to sports typically occurs between 4 and 6 months post-operatively.

When to Seek Care

You should schedule a consultation if:

  • Your shoulder has dislocated more than once or feels like it is "slipping" during daily tasks or sleep.

  • You experience a painful "catch" or "clunk" when reaching overhead or behind your back.

  • You have a sense of "apprehension" or fear that your shoulder will come out of joint during sports.