Open Bankart Repair in Contact Athletes: Why and How

Anterior shoulder instability is a common problem in athletes. The risk factors for recurrent instability include young age, male gender, number of previous instability events, and contact or collision sport participation. Owing to the high rate of recurrent instability in the young athlete, surgical management is often indicated. Although arthroscopic Bankart repair has grown in popularity over the last several years, we still consider the open Bankart repair with capsular shift a superior form of treatment in the highest-risk patient (ie, the young male collision athlete). Arthroscopy followed by open repair allows the surgeon the opportunity to address all critical aspects at once—Bankart repair, capsular tensioning, rotator interval closure, bony defects, and any humeral avulsion glenohumeral ligament lesions. In this report, we review the indications for open Bankart repair in athletes and describe in detail our particular surgical approach and rehabilitation protocol.