What Causes Bankart Lesions?

The shoulder is one of the most significant joints in our bodies, providing a broad range of motion and functionality. In a healthy joint, the ball (humeral head) is firmly positioned in the socket (glenoid). Its stability is reinforced by ligaments and the connective ring of fibrocartilaginous tissue surrounding the socket known as the labrum. 

Shoulder trauma caused by injuries or overuse can produce dislocation or subluxation that separates the ligaments and tears the labrum. Left untreated, labrum tears may lead to chronic shoulder instability, easily causing repeated dislocations. 

Bankart lesions occur during anterior shoulder dislocation when the humeral head is forced either forward or downward and pushes against the anterior labrum covering the socket. When the tear also involves a bone fracture in the shoulder socket, the injury is referred to as an osseous Bankart lesion. 

Leading Causes

Bankart lesions are most frequent in young individuals in their 20s, although they can affect anybody. They commonly occur due to high-energy trauma and injuries resulting from sports or occupational activities. Leading causes include:

• Automobile Accidents – A forceful blow resulting from cars colliding can knock the humeral head out of the socket tearing the labrum in the process.  
• Athletic Collisions – Most common in sports that involve athletes crashing into competitors at high speeds with massive force, as in football, hockey, rugby, or lacrosse.
• Athletic Falls – Losing balance and landing improperly on the shoulder can lead to dislocations, especially in disciplines that involve speed and height like basketball, gymnastics, and skiing. 
• Non-Athletic Falls – Similar to athletic injuries, landing on the shoulder after falling off a ladder, losing balance, or tripping may deliver sufficient force to cause dislocation and damage the labrum.  
• Overuse – Athletes involved in disciplines such as weight lifting, swimming, tennis, volleyball, or baseball are the most susceptible. Non-athletes whose occupations require similar repetitive shoulder movements can also experience Bankart lesions, as is the case in construction jobs, carpentry, and painting.  
• Ligament Issues – Some people are genetically predisposed to having loose ligaments, as is the case of double-jointed individuals who may find that their shoulders suffer frequent misalignments. In such cases, treatment is more complex than in the case of regular Bankart lesions.  

Ignoring Bankart lesions can lead to chronic shoulder instability that requires operative treatment to reattach the torn labrum, using either arthroscopic surgery or open Bankart repair.