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Arthroscopic Bankart Repair Using a Lateral Distraction Jack

March 01, 2020

Contributors: Niloy Ghosh, BS; Dylan Lowe, MD; Andrew S Rokito, MD, FAAOS; Devon J Ryan, MD

Typically, arthroscopic Bankart repair is the first line of surgical treatment for patients with anterior shoulder instability who do not have considerable bone loss. Arthroscopic Bankart repair involves reattachment of the anterior labrum and capsule to the glenoid rim with the use of suture anchors. Access to the anterior glenoid may be a challenge and often requires an assistant to manually distract the arm and open the joint space. This video demonstrates arthroscopic Bankart repair with the use of a lateral distraction jack, which obviates the need for an assistant to manually hold traction on the extremity. The video discusses the case presentation of a 16-year-old boy who sustained a traumatic left shoulder dislocation while being tackled during a football game. Since his injury, the patient has experienced multiple instability events during heavy lifting and wrestling and when reaching behind his back. The patient attempted physical therapy for approximately 3 months, which did not result in any resolution of his symptoms. MRI revealed a characteristic Bankart lesion without substantial glenoid bone loss, and arthroscopic Bankart repair was indicated. The video presents detailed footage from the operating room. A preoperative examination under anesthesia is performed, and the patient is placed in the lateral decubitus position. Set up of the lateral distraction jack is then demonstrated. The lateral distraction jack is attached to the contralateral side of the surgical table and draped so it can be brought into the surgical field in a sterile manner. Arthroscopic Bankart repair, including the use of a lateral distraction jack to facilitate the procedure, is then shown. The patient's arm was placed in a sling for 6 weeks postoperatively. The patient began a progressive physical therapy program 2 weeks postoperatively. The patient was cleared to resume full athletic activity approximately 5 months postoperatively.

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