Bankart Lesions, Medical Treatments and Rehabilitation Outcomes
On May 17, 2019, Yong Hwan Kim and Wi-Young So have published an article entitled “Effects of Rehabilitation in Bankart Lesion in Non-athletes: A report of three cases” in Open Medicine.
A Blog Post by Pablo Markin.
In their paper, Yong Hwan Kim and Wi-Young So have explored the treatment of Bankart lesions, usually involving shoulder dislocation and upper arm damage, which is a common traumatic injury in sports, to compare “medical treatment, [and] rehabilitation outcomes at 3 and 8 months” (369) across a limited number of medical cases. This study also serves the purpose of analyzing “the long-term effects of non-surgical therapies […] and developing effective exercise rehabilitation programs” (369). As these authors indicate, “[t]he most frequent treatment for a Bankart lesion is orthopedic reduction of the dislocation and surgical repair, with suturing to stabilize the [glenoid] labrum[, which refers to a fibrocartilaginous structure in the shoulder blade,] when the extent of the tear is significant” (369).
As scholarly literature suggests, “after a first traumatic dislocation, recurrence can occur more easily, leading to habitual instability […] [which demands] [m]uscle strengthening, stabilization exercises and neuromuscular control” (369). The rehabilitation routine applied to one of the researched patients “consisted of exercises prescribed by the surgeon and supervised by a medical specialist during hospital-based session[s], and augmented by a home program of exercise” (370). This course of treatments has allowed avoiding surgery in this case, due to “the absence instability and recurrent dislocation, despite the structural defect in the labrum, attesting to the compensation provided by the musculature” (372). Similar results were obtained for other differently aged patients, such as the post-treatment absence of pain or limitations in the “activities of daily living […] and exercise” (372).
Furthermore, Kim and So note that there is a “controversy regarding the benefit of surgical repair, even in younger athletes, [that] stems from findings of a rate of recurrence [of] >15% in young adults, athletes, and individuals with high activity levels, despite surgery” (372). These authors, thus, conclude that “an initial program of rehabilitation, with frequent follow-up, should be tried prior to selecting surgical repair” (374). However, this paper also suggests that, even with a “conservative management of a Bankart lesion […], the resulting increase in strength and stabilization cannot prevent against recurrent […] dislocation under unpredictable conditions, including occupational activities, recreational activities (such as skiing), and everyday activities, such as sudden lifting” (374).
By Pablo Markin
Featured Image Credits: Shoulder dislocation, October 30, 2010 | © Courtesy of Gordon Anderson/Flickr.