Bankart's 1938 paper defines the pathoanatomy of recurrent anterior shoulder dislocation from direct operative inspection. The central question: what structural lesion causes dislocation to recur, and how should it be corrected? The answer comes from 27 consecutive operative cases examined firsthand.
Every anterior shoulder instability case you manage traces back to this paper. Bankart established that the labral avulsion is the structural lesion driving recurrence, and that it will not heal without surgical reattachment to bone.
When a young athlete presents with recurrent anterior instability after a posteriorly directed injury, the lesion is predictable: the labrum is off the bone, the anterior glenoid rim is bare, and no amount of immobilization will fix it. The correct treatment is anatomic restoration — reattach the labrum to a prepared anterior glenoid surface. Modern arthroscopic Bankart repair with suture anchors is the direct descendant of the open technique described here.
One nuance worth knowing: Bankart explicitly states the capsule is NOT lax in these patients. Procedures adding capsular volume reduction address a different target. This matters when deciding whether an isolated Bankart repair suffices or whether bone-block augmentation (Latarjet) is needed for cases with significant glenoid bone loss. A question Bankart's paper frames but does not resolve.
Bankart's 1938 paper defines the pathoanatomy of recurrent anterior shoulder dislocation from direct operative inspection. The central question: what structural lesion causes dislocation to recur, and how should it be corrected? The answer comes from 27 consecutive operative cases examined firsthand.
Every anterior shoulder instability case you manage traces back to this paper. Bankart established that the labral avulsion is the structural lesion driving recurrence, and that it will not heal without surgical reattachment to bone.
When a young athlete presents with recurrent anterior instability after a posteriorly directed injury, the lesion is predictable: the labrum is off the bone, the anterior glenoid rim is bare, and no amount of immobilization will fix it. The correct treatment is anatomic restoration — reattach the labrum to a prepared anterior glenoid surface. Modern arthroscopic Bankart repair with suture anchors is the direct descendant of the open technique described here.
One nuance worth knowing: Bankart explicitly states the capsule is NOT lax in these patients. Procedures adding capsular volume reduction address a different target. This matters when deciding whether an isolated Bankart repair suffices or whether bone-block augmentation (Latarjet) is needed for cases with significant glenoid bone loss. A question Bankart's paper frames but does not resolve.