Bankart Lesion (Glenoid Labrum Tear)

What is a Bankart lesion (glenoid labrum tear)?

A Bankart lesion is an injury to the connective tissue that helps hold your shoulder in its socket. It happens when your shoulder gets forced out of the front of its socket and into the connective tissue.

Your shoulder is where the rounded top of your upper arm bone (humerus) fits into the socket of your shoulder blade (scapula). A ring of cartilage lines and extends the socket to support the shoulder joint.

This ring of cartilage is called your glenoid labrum. When your shoulder bone is forced out of its socket and into the glenoid labrum, it can tear it or even separate it from the bone. This is a Bankart lesion.

A healthcare provider can move your dislocated shoulder back into place, but this won’t fix a Bankart lesion. This longer-lasting injury leaves your shoulder joint unstable and more likely to dislocate again.

How common are Bankart lesions?

Shoulder dislocations are the most common type of shoulder injuries. They affect about 1% of the population. About 90% of shoulder dislocations are anterior, which means to the front of the socket.

Anterior shoulder dislocations are most likely to cause a glenoid labrum tear — and between 87% and 100% of them do. So, if you’ve dislocated your shoulder, you’re very likely to have a Bankart lesion.

What is a bony Bankart lesion?

Your healthcare provider might say you have a bony Bankart lesion if your glenoid labrum and your shoulder socket bone (glenoid) are both injured. That means the tissue is torn and the bone is fractured.

Bony (or osseous) Bankart lesions are less common than soft (or fibrous) Bankart lesions, which only affect your glenoid labrum. About 73% of anterior shoulder dislocations involve a bony Bankart lesion.

What causes a Bankart lesion?

A Bankart lesion or glenoid labrum tear happens when your shoulder bone dislocates and tears the supportive tissues around it. A dislocated shoulder is a traumatic injury caused by significant force.

Common causes of shoulder dislocations include:

• Car crashes.
• Sports injuries.
• Falls.

What are the symptoms of a Bankart lesion?

Bankart lesion symptoms can include:

• Shoulder pain: You might feel generalized shoulder pain, or you might feel it in the lower front part of your shoulder socket. Notice if it's consistent and doesn’t improve with time and rest.
• Limited range of motion: You might have difficulties with shoulder movements like lifting, throwing or reaching. Some people have difficulties getting dressed or putting on a seatbelt.
• Mechanical symptoms: You might feel a grinding or popping sensation when your shoulder joint moves a certain way, or you might feel the bone catch and lock in place, followed by soreness.
• Shoulder instability: You might notice that your shoulder joint feels loose or that the bone seems to move too much when you rotate your shoulder. It might even dislocate again.

How is a Bankart lesion diagnosed?

A healthcare provider will start by asking you about your shoulder injury — when and how it happened, and if it’s ever happened before. They’ll physically examine your shoulder joint for signs of instability.

They’ll follow up with imaging tests to see the injury. Tests usually include X-rays and an MRI (magnetic resonance imaging). They’ll want to see the extent of the damage to your glenoid labrum and if there are any other injuries.

Do Bankart lesions need surgery?

Not all glenoid labrum tears need surgery, but some do. Bankart lesions can heal by themselves, but some may not heal as well without surgical repair. Your healthcare provider might recommend surgery for you if:

• Your glenoid labrum detached from the bone and needs surgery to reattach it.
• You have a bony Bankart lesion and lost some of the bone.
• You have recurring shoulder instability from a previous injury.
• Your regular activities or occupation relies heavily on your shoulder joint.

What happens if a Bankart lesion is left untreated?

Bankart lesions can heal without treatment, but they don’t always heal well enough, and sometimes, your shoulder joint remains unstable. This makes it more likely to dislocate and tear your labrum again.

Your healthcare provider is the best person to tell you if your injury is likely to heal well on its own. Even if you don’t have surgery, you’ll need to take good care of your shoulder joint for it to heal well.

What is surgical repair for a Bankart lesion?

Surgery for a Bankart lesion involves removing dead or damaged tissue and repairing the tear in the healthy tissue. If necessary, your surgeon will reattach your glenoid labrum to the glenoid bone.

Surgeons attach small anchors to the socket bone and stitch the glenoid labrum tissue to these anchors. They carefully tighten the stitches to restabilize the joint. This is sometimes called a Bankart repair.

Surgeons can often complete a Bankart repair by shoulder arthroscopy. That means they insert a small tube with a camera at the end (arthroscope) through a small incision and operate through the tube.

Minimally invasive surgery methods like shoulder arthroscopy make recovery faster and easier. But sometimes, for more severe injuries, you might need open shoulder surgery to repair it properly.

What is the rehabilitation process for a Bankart lesion?

Whether you have surgery or not, your shoulder will need rest and rehabilitation to recover. This means keeping your shoulder immobilized in a sling for several weeks. Afterward, you’ll need physical therapy.

A physical therapist will give you a course of exercises to follow to recover your muscle strength and range of motion gradually. This also helps to restabilize the joint and reduce the risk of recurrence.

What’s the outlook with a Bankart lesion?

You may or may not need surgery for a Bankart lesion. In both cases, the outlook afterward is good. Most people recover well from a Bankart lesion, although full recovery can take up to six months.

The biggest risk after recovery is persistent shoulder instability causing your shoulder to dislocate and tear your labrum again. This is less likely after surgery and if you follow through with physical therapy.

What’s the difference between a Bankart lesion and a Hills-Sachs lesion?

A Hills-Sachs lesion and a Bankart lesion can happen for the same reason and, often, at the same time. When your shoulder bone forcefully dislocates, it jams against the rim of the shoulder socket.

This can tear the cartilage around the rim (your glenoid labrum), which is what a Bankart lesion is. It can also damage the shoulder bone itself, putting a dent in it. This is what a Hills-Sachs defect or lesion is.

What’s the difference between a Bankart lesion and a SLAP tear?

A SLAP tear is another type of glenoid labrum tear that occurs on the top portion, from front to back. SLAP stands for Superior Labrum (top part of the labrum) Anterior to Posterior (front to back) tear.

This type of tear is less likely to happen from a shoulder dislocation. Instead, it often happens with forceful shoulder movements. It can tear all at once or gradually over time with repetitive strain.

Bankart lesions and SLAP tears have similar symptoms and potential complications. They can both destabilize your shoulder joint, causing pain and a risk of dislocation. Both might need surgical repair.

You’re more likely to have a SLAP tear if you don’t remember dislocating your shoulder and if you feel pain over the top of your shoulder socket. If you feel it in the lower front, it might be a Bankart lesion.

A note from Cleveland Clinic

If you dislocate your shoulder, you’re likely to also tear your glenoid labrum. This injury can have farther-reaching effects than the shoulder dislocation itself. In some cases, you might need surgery to repair it.

Recovery from a Bankart lesion takes some time and effort, including several months of physical therapy. But most people who complete this program fully recover the use of their shoulder, including athletes.