Anterior recurring dislocation with labral tear (Bankart lesion)

This baseball player had an injury during a diving catch and dislocated his shoulder. It is not common to see this type of injury from repetitive throwing, but rather from one sudden, more severe injury. The dislocating shoulder tore the labrum, and that caused his shoulder to repeatedly dislocate with very little additional trauma. Sometimes it woud dislocate with simple reaching overhead and behind the back.

	The labrum is hooked by the surgeon's probe, and can be seen to be detached from the bone.
	The remainder of the labrum is quite frayed and torn almost all the way around.
	This shows the 2 "cannulas" used to allow easy placement of instruments in the joint during the surgery. These are just long, hollow tubes that allow control of water flow, since the joint is full of water during surgery.
	The bone is shaved with the burr to roughen it and prepare for labral reattachment.
	The suture is looped around the labrum and through the anterior capsule to not only reattach the labrum, but also to tighten up the capsule. Because the capsule was stretched out from all the dislocations, it is necessary to tuck it in.
	The first suture has been secured into the bone, and the second one is passed around the labrum and more capsule.
	The suture anchor is seen with the second suture passed through it. The hole for the anchor has been drilled, and I am about to push the anchor into the hole, which will secure the soft tissue tightly to the bone.
	Now 2 anchors have been placed, and the third one is being pushed into it's hole. You can see the ribs which help hold the anchor into the bone more securely.

Arthrex Push-Lock Suture Anchor Animation - an animation done by Arthrex that might clarify the details of placing the sutures in the above surgical procedure. If you watch this animation closely, please note that we at SafeThrow use a technique that is improved over the one depicted in that animation. The technique in the animation shows each suture passed one time around the labrum. The improved technique, demonstrated in the above sequence of photographs, loops the suture and thus passes each suture around the labrum TWICE. This gives greater contact area of the labrum to the bone under the suture, and increases the strength each anchor provides to the repair.