The first shoulder dislocation is dramatic. A tackle, a fall, an awkward throw — and the arm is locked, held against the body, intensely painful until someone puts it back.
What happens afterwards is less dramatic and more important. For a young person who dislocates playing sport, the chance of it happening again is high — and each dislocation does a little more damage. Bankart repair in Faridabad is the operation that breaks that cycle.
Dr. Sunil Choudhary, FRCS (Trauma & Orthopaedics), with two UK shoulder fellowships including dedicated training in shoulder instability surgery.
Why a shoulder keeps dislocating
The shoulder socket is shallow — roughly the proportions of a golf ball on a tee. Its stability comes from a rim of fibrocartilage called the labrum, which deepens the socket, and from the ligaments attached to it.
When the shoulder dislocates forwards, the labrum is commonly torn off the front and lower part of the socket. That injury is a Bankart lesion. Because the labrum does not reliably reattach itself, the socket stays effectively shallower than it should be — and the shoulder dislocates again more easily, with progressively less force each time.
A Hill-Sachs lesion — a dent in the back of the humeral head where it impacted the rim — often accompanies it. If that dent is large and the socket has also lost bone, the two can engage with one another, and soft-tissue repair alone will not hold.
Who is at highest risk of recurrence
- Age under 25 at first dislocation — by far the strongest predictor
- Male sex
- Contact or collision sport — cricket, kabaddi, football, wrestling, rugby
- Overhead sport — cricket bowling, badminton, volleyball, swimming
- Generalised ligamentous laxity
- Glenoid bone loss already present
- More than one previous dislocation
A patient over forty with a first dislocation is in a different situation: they are less likely to re-dislocate, but considerably more likely to have torn their rotator cuff repair at the same time, and that needs looking for.
How we assess instability and bone loss
Examination includes apprehension and relocation tests, assessment of generalised laxity, and testing for posterior and multidirectional instability — because not all instability is anterior, and treating the wrong direction does not work.
Imaging: X-rays to assess bone and check for a bony Bankart; MRI or MR arthrogram to show the labral tear and associated soft-tissue injury; and CT where there have been multiple dislocations, to quantify glenoid bone loss accurately.
Bone loss is the deciding factor. As a best Bankart repair surgeon in Faridabad would advise: if glenoid bone loss exceeds roughly 20 to 25 per cent, an arthroscopic soft-tissue repair has a high failure rate, and a bone-block procedure is needed instead.
Arthroscopic Bankart repair — the procedure
Through two or three small incisions, the detached labrum is mobilised, the bone edge of the glenoid prepared, and the labrum reattached with suture anchors — typically three or four — restoring the depth of the socket and re-tensioning the ligaments. Where the capsule is stretched, it is tightened at the same time.
Surgery takes around 60 to 90 minutes under general anaesthesia with a nerve block, usually as a day case.
When a Latarjet is needed instead
Where there is significant glenoid bone loss, or where a previous Bankart repair has failed, the Latarjet procedure is used. A portion of the coracoid process with its attached muscles is transferred to the front of the glenoid. This works in three ways at once: it replaces the missing bone, deepens the socket, and the transferred muscles act as a dynamic sling across the front of the joint.
It is a bigger operation than a Bankart repair, but in a shoulder with bone loss it is substantially more reliable — and offering a soft-tissue repair in that situation sets the patient up for another failure.
Recovery and return to contact sport
- Weeks 0–4 — sling, with movement limited to protect the repair. No external rotation beyond the specified limit
- Weeks 4–8 — sling discarded, range of movement progressively restored
- Months 2–4 — strengthening, with emphasis on the rotator cuff and scapular stabilisers
- Months 4–6 — sport-specific training, proprioception and controlled contact drills
- Month 6 onwards — return to contact and overhead sport, based on strength and stability testing
Frequently asked questions
I have dislocated once. Should I have surgery now?
It depends mainly on your age and sport. For a 19-year-old contact athlete, early stabilisation after a first dislocation is increasingly supported, because recurrence is very likely and each further dislocation causes more bone loss. For a 45-year-old with a single dislocation from a significant fall, rehabilitation is usually tried first — but the rotator cuff must be assessed.
Can physiotherapy alone stop a shoulder dislocating?
It can help considerably where instability is due to laxity and poor muscle control rather than a torn labrum — particularly in multidirectional instability, where rehabilitation is the primary treatment. Where there is a structural Bankart lesion, physiotherapy improves control but does not repair the labrum.
What is the success rate of Bankart repair?
In appropriately selected patients without significant bone loss, recurrence rates after arthroscopic repair are low. Failure is most often associated with unrecognised glenoid bone loss, return to contact sport too early, or very young age at the time of first dislocation.
Will I lose movement after the operation?
A small loss of external rotation is possible, and it is partly deliberate — the repair tightens a capsule that had become stretched. Most patients regain functional range, and overhead athletes are assessed with their specific sport demands in mind.
Where is shoulder instability surgery performed in Faridabad?
At the Asian Institute of Medical Sciences, Sector 21A — the Bankart repair clinic in Faridabad, with CT bone-loss assessment available and both arthroscopic Bankart and Latarjet procedures offered.
Author & Medical Review
Medically reviewed by Dr. Sunil Choudhary, MBBS, MS, DNB, MRCS, FRCS (Tr & Orth).
