Arthroscopic Anterior Labral Repair With Capsulorrhaphy and Interval Closure: Surgical Technique

Traumatic anterior labral injuries (Bankart lesions) lead to anterior shoulder instability. Arthroscopic anterior labral repair (also known as Bankart repair) provides a soft tissue reconstruction to reduce the risk of dislocation. However, the described techniques vary significantly. We present our technique for enhancing the quality and volume of tissue incorporated in the repair and utilizing interval closure to further reduce recurrent instability rates.

Non-throwing athletes or high-demand patients with recurrent instability after a traumatic event with <20% glenoid bone loss. This can include young patients (<25 years) who are first-time dislocation patients participating in high-risk sports.

Shoulder arthroscopy is performed in the lateral position with a standard posterior portal and 2 anterior portals. While viewing from the posterior portal and working from the anterosuperior portal, the labral and capsular tissues are completely elevated from the anterior and inferior glenoid. The native labral footprint on the glenoid is prepared for repair using a hooded bur. Sutures are passed through the capsulolabral tissue with a self-retrieving device. The first suture is passed into the inferior labral tissue from the anteroinferior portal. In contrast, subsequent suture passages along the anterior glenoid are performed from the posterior portal, all while viewing from the anterosuperior portal. The tissue is then sequentially advanced into the knotless anchors along the anterior face of the glenoid, creating a robust soft tissue restraint to glenohumeral instability. An arthroscopic rotator interval closure is then performed for further stability.

A review of this procedure in 38 active patients with at least 2 years of follow-up demonstrated an improved outcome score, with a 10.5% rate of redislocation. Two shoulders underwent revision surgery for recurrent instability.

Arthroscopic anterior labral repair with capsulorrhaphy and interval closure effectively reduces recurrent anterior shoulder instability. This video demonstrates techniques for enhancing the quality and quantity of soft tissue incorporated into the repair.

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