Okay so please help me out here. I've been told there are two ways to have my dislocating shoulder repaired. The operation is called a Bankart repair. They can do it open or closed. Which is better? How do I know which one to choose? Do I get a choice?

You'll want to discuss this decision with your surgeon. He or she may have a preference based on training and experience and/or based on specific factors that only apply to you.

The Bankart repair is for a shoulder injury of the labrum. The labrum is a dense ring of fibrous cartilage that is attached to the acetabulum (socket) of the shoulder joint. It gives the socket a little more depth and stabilizes the head of the humerus (upper arm bone) in the joint.

Repeated shoulder dislocations in the forward direction cause the labrum to tear away from the acetabulum. Surgery is needed to shave any loose fragments and reattach the labrum. The operation can be done with an open incision, which involves cutting through the subscapularis tendon.

Open repair gives the surgeon a better view of the area but has the downside of causing damage to the soft tissues. Fibrosis and scarring can occur during the healing process. These factors can delay recovery.

The closed or arthroscopic method involves the insertion of a long, thin needle into the joint. A tiny TV camera on the end of the scope gives the surgeon a view inside the joint without opening it up.

There is a minimal scar (puncture size) and less risk of complications. Arthroscopic surgery is also shorter with less postoperative pain. And according to a recent study, muscle strength returns to normal sooner with arthroscopic surgery. So if you are an athlete or sports participant, this feature may be of some particular interest to you.

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