Arthroscopic Bankart repair. Operative technique and surgical pitfalls

The arthroscopic management of patients with shoulder instability continues to evolve. The obvious benefits include a reduction of operative time, preservation of the subscapularis, improved visualization, and less blood loss. Newer techniques that allow the plastic deformation of the IGHLC to be addressed are emerging, which may yield results as successful as those of open Bankart repair. The ability to adequately tension the IGHLC may result in some loss of external rotation, which may improve results. Capsular tensioning must be critically analyzed at the time of surgery. Adequate stabilization with an arthroscopic approach should provide a convincing postoperative examination of stability. A careful examination after suture placement may indicate residual laxity that must be addressed. Finally, periods of immobilization are similar in open and arthroscopic techniques. The process of biologic healing is not accelerated by arthroscopic techniques, and early return to sport activities that may endanger the repair will likely result in early failure.