This cadaveric biomechanical study asked whether detachment of the anterior inferior glenohumeral ligament from the glenoid (a simulated Bankart lesion) is sufficient to produce pathologic anterior instability. Nine fresh cadaveric shoulders were tested intact and after simulated Bankart lesion creation, with multidirectional translations measured under 50 N applied loads across multiple positions of elevation and rotation.
A Bankart repair that reattaches the labrum and capsule to the glenoid rim does not fully address the pathology of recurrent anterior instability — this paper is why. The detachment itself produces only a 1-3 mm increase in anterior translation. The true culprit enabling dislocation is permanent elongation of the inferior glenohumeral ligament complex, which must be addressed at surgery.
When you see a failed Bankart repair, think capsular stretch first. Rowe et al. Found capsular elongation in 86% of failed stabilization procedures. Failing to recognize and address this redundancy is the most likely explanation for recurrence.
This biomechanical evidence is why modern instability surgery pairs anatomic Bankart repair with capsular plication or shift when redundancy is present. Reattachment alone is not enough if the ligament has been permanently stretched.
This cadaveric biomechanical study asked whether detachment of the anterior inferior glenohumeral ligament from the glenoid (a simulated Bankart lesion) is sufficient to produce pathologic anterior instability. Nine fresh cadaveric shoulders were tested intact and after simulated Bankart lesion creation, with multidirectional translations measured under 50 N applied loads across multiple positions of elevation and rotation.
A Bankart repair that reattaches the labrum and capsule to the glenoid rim does not fully address the pathology of recurrent anterior instability — this paper is why. The detachment itself produces only a 1-3 mm increase in anterior translation. The true culprit enabling dislocation is permanent elongation of the inferior glenohumeral ligament complex, which must be addressed at surgery.
When you see a failed Bankart repair, think capsular stretch first. Rowe et al. Found capsular elongation in 86% of failed stabilization procedures. Failing to recognize and address this redundancy is the most likely explanation for recurrence.
This biomechanical evidence is why modern instability surgery pairs anatomic Bankart repair with capsular plication or shift when redundancy is present. Reattachment alone is not enough if the ligament has been permanently stretched.