Bankart Lesion

A Bankart lesion is a specific type of injury to the shoulder joint, more precisely to the anterior (front) part of the glenoid labrum the cartilage rim attached to the socket of the shoulder blade (1). It is commonly associated with anterior shoulder dislocations, where the head of the humerus (upper arm bone) is forced out of its socket. Named after British orthopedic surgeon Arthur Bankart, who first described the lesion in the 1920s, this condition is most often seen in young, active individuals involved in contact sports or activities with a high risk of shoulder trauma. A Bankart lesion can cause recurrent shoulder instability and greatly affect an individual’s ability to perform everyday activities and sports (2).

Symptoms

The symptoms of a Bankart lesion can vary depending on the severity of the injury and whether or not the shoulder dislocation is recurrent (2). Common signs and symptoms include

• Shoulder instability: A feeling that the shoulder may “slip out” or dislocate during movement.
• Recurring dislocations: Multiple instances of the shoulder dislocating, especially during physical activity.
• Pain: Often located at the front of the shoulder and exacerbated by overhead movements or lifting (1) .
• Weakness: A noticeable reduction in shoulder strength, particularly when raising the arm.
• Catching or clicking sensation: A mechanical sensation in the shoulder during movement.
• Limited range of motion: Difficulty or discomfort when attempting to move the shoulder in certain directions.

In cases of a first-time dislocation, the symptoms might be acute and more intense, while in chronic cases, the symptoms are often more subtle but persistent (2).

Causes

A Bankart lesion is most commonly caused by trauma that results in a shoulder dislocation (3). The glenohumeral joint, which connects the humerus to the scapula, is the most mobile joint in the body, making it vulnerable to dislocation. The lesion occurs when the dislocation tears the labrum from the glenoid cavity, compromising the stability of the shoulder (3).

Typical causes include

• Sports injuries: Especially in contact or overhead sports like football, rugby, swimming, volleyball, or baseball.
• Falls: A sudden fall on an outstretched hand or directly onto the shoulder.
• Trauma: Motor vehicle accidents or blunt force trauma.
• Repetitive strain: In some cases, repetitive overhead motion may lead to gradual wear and tear, causing a labral tear.

Risk Factors

Several factors increase the likelihood of developing a Bankart lesion, including

• Age: Young adults, especially those between the ages of 15 and 30, are at higher risk due to their active lifestyle and the tendency for more forceful injuries (1).
• Gender: Males are more commonly affected, likely due to greater participation in high-risk activities or contact sports.
• Sports involvement: Participation in high-impact or overhead sports.
• Previous dislocations: Individuals who have experienced one shoulder dislocation are at higher risk of recurrent dislocations and Bankart lesions.
• Hypermobility or lax ligaments: Some individuals naturally have looser ligaments, increasing joint instability.

Diagnosis

A thorough clinical evaluation is essential to diagnose a Bankart lesion. The diagnostic process typically involves

1. Medical history and physical examination: A doctor will assess symptoms, previous dislocations, and shoulder instability. Specific tests such as the apprehension test or relocation test may be used to evaluate shoulder stability (3).
2. Imaging studies
   • X-rays: Useful for identifying fractures or the extent of dislocation.
   • Magnetic Resonance Imaging (MRI): Especially with contrast (MR arthrogram), this is the most effective way to visualize soft tissue damage like labral tears.
   • CT scans: Occasionally used to evaluate bone damage or glenoid bone loss, particularly in chronic or severe cases.

Accurate diagnosis is crucial for determining the appropriate course of treatment (2).

Treatment Options

The treatment for a Bankart lesion depends on factors such as the severity of the injury, the patient’s age, activity level, and whether shoulder dislocations are recurrent (3).

Non-Surgical Treatment

For first-time dislocators or less severe cases, especially in older or less active patients

• Immobilization: The arm may be placed in a sling for several weeks.
• Physical therapy: Focuses on restoring range of motion, strengthening shoulder muscles, and improving joint stability.
• Activity modification: Avoidance of activities that strain the shoulder.

However, non-surgical treatment has a higher rate of recurrence, especially in young athletes (1).

Surgical Treatment

Surgical intervention is often required for active individuals or those with recurrent dislocations. The primary goal is to restore shoulder stability.

• Arthroscopic Bankart repair: Minimally invasive procedure where the torn labrum is reattached to the glenoid using sutures and anchors.
• Open Bankart repair: Involves a larger incision and is used in more complex or recurrent cases.
• Bony procedures: In cases with significant bone loss, procedures like the Latarjet may be considered, where a piece of bone is transferred to the shoulder to reinforce stability.

Post-operative recovery involves several months of rehabilitation.

Living With or Prevention

Living With a Bankart Lesion
Recovery after a Bankart repair typically takes about 4 to 6 months. During this time, patients undergo a staged rehabilitation program:

• Phase 1 (0 to 6 weeks): Shoulder immobilization and passive motion exercises.
• Phase 2 (6 to 12 weeks): Gradual reintroduction of active movement.
• Phase 3 (3 to 6 months): Strengthening and return-to-sport protocols.

Long-term outcomes are generally positive, especially with surgical intervention. However, adherence to physical therapy and avoiding high-risk activities during recovery are essential.

Prevention Tips

• Strength training: Focus on rotator cuff and scapular stabilizer muscles to enhance shoulder stability (3).
• Warm-up routines: Proper stretching before physical activity.
• Technique correction: Athletes should be trained in safe techniques for contact or overhead movements.
• Protective gear: Use of braces or taping during sports if advised by a physician.

References

1. Wu F, Yang W, Meng C, Wang H, Huang W. A Simplified Technique for Arthroscopic Reduction and Double-Pulley Fixation of Bony Bankart Lesion by Percutaneous Spinal Needle Suture. Arthrosc Tech. 2025 Mar 18;14(6):103508. doi: 10.1016/j.eats.2025.103508. PMID: 40656729; PMCID: PMC12255397.
2. Ji X, Ye L, Hua Y, Zhou X. Arthroscopic repair with transosseous sling-suture technique for acute and chronic bony Bankart lesions. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Sep 15;34:9-14. doi: 10.1016/j.asmart.2023.08.008. PMID: 37744966; PMCID: PMC10511304.
3. Sethi S, Reddy S, Sakarvadia M, Serotte J, Nwaudo D, Maassen N, Shi L. SCOPE-MRI: Bankart Lesion Detection as a Case Study in Data Curation and Deep Learning for Challenging Diagnoses. ArXiv [Preprint]. 2025 Apr 29:arXiv:2504.20405v1. PMID: 40395941; PMCID: PMC12091705.