After sustaining a shoulder dislocation, a Bankart tear is a common injury. Because the ligaments of the front of the shoulder helps maintain the joint in proper position, a Bankart tear (a tear of the inferior glenohumeral ligament), will make the shoulder prone to repeat dislocation.
Chance of Repeat Dislocation
The chance of the shoulder dislocating after a Bankart tear depends most significantly on the age of the patient. Younger patients are most likely to sustain a Bankart tear if their shoulder dislocates, and are therefore more likely to have a repeat shoulder dislocations. Statistically, the chances of a second dislocation the shoulder are greater than 80% in patients younger than 30 years of age. Over 30 years old, the chance of a repeat dislocation drops significantly.
Bankart Tear Surgery
Some orthopedic surgeons recommend surgery to repair a Bankart tear after an initial shoulder dislocation in young athletes. The usual treatment after a shoulder dislocation is a period of rest, followed by aggressive physical therapy, then a gradual return to activities. If the shoulder dislocates again, surgery is usually considered.
Some orthopedic surgeons will repair a Bankart tear after one dislocation in young athletes. Because the chance of repeat dislocation is so high, especially in athletes who participate in contact sports, this type of immediate Bankart repair can be justified. The concern of these surgeons, is that every time a shoulder dislocation occurs, damage can occur to the joint, including cartilage damage. Therefore, if there is a very high chance of repeat dislocation, then steps should be taken to prevent that from occurring.
Should You Have Surgery?
There is no right answer to this question, and every patient needs to consider their individual situation. It is true that young athletes, especially those who participate in contact sports (e.g. football, hockey), who dislocate their shoulder will have a very high chance of a repeat dislocation without surgery.
Patients should discuss with their orthopedic surgeon the likelihood of repeat dislocation given their age, activity level, and injury, and from this determine if surgery is appropriate. Patients considering surgery must also understand that return to unrestricted sports activities will be about 4-6 months, and even surgery does not guarantee that further dislocations will not occur.
Kirkley A, et al. "Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: long-term evaluation." Arthroscopy. 2005 Jan;21(1):55-63.