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Techniques-Open Anatomic Repair

The classic open Bankart repair, Neer capsular shift, and multiple subsequent modifications have been reported for many years In the appropriate patient population and while adhering to meticulous surgical technique, the results are consistently very good. With Rowe et al.

It reporting 97% and 95% success rates respectively with open anterior stabilization, it is not surprising that open techniques such as the Bankart are heralded as the “gold standard.”

The Bankart procedure restores normal anatomy by reattaching the labrum to its anatomic position at the anterior articular margin of the joint The concept of a “selective capsular shift” was introduced as a refinement to this technique .

The selective shift is based on the observation that the capsuloligamentous static stabilizers function at predictable positions of rotation and act as checkreins to excessive rotation and translation and that the pathoanatomy involves injury to both the labrum and the capsule.

The Bankart lesion is anatomically repaired and then the capsule is shifted to tighten the joint while avoiding over-constraint.

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