Shoulder-related injuries are a common occurrence with football players of all ages and skill levels. In fact, shoulder dislocations and acromioclavicular joint separations represent almost half of all shoulder injuries among athletes playing in contact or extreme sports.
When Dylan dislocated his shoulder during a routine football play, he could sense his dream of playing out his final high school football season fading away.
“My shoulder injury occurred during a 7-on-7 scrimmage out at a UCF camp. I was in man coverage on the running back; he was running a slant,” Dylan remembers vividly. “It was a non-contact injury, my arm just got caught in his arms, and my shoulder pulled up when I was swinging to break up a pass.”
The youngest of three brothers, his two siblings already playing collegiate level football, Dylan hoped this season would solidify his chances for obtaining a scholarship with a large NCAA program.
“The first thing that went through my mind was, the season is a month away,” says Dylan. “If I have surgery, I’m definitely not playing the regular season, and I figured I wasn’t going to play in the post-season either. So I kind of figured my high school career was over. That’s a bit of a shock.”
In an attempt to salvage his season, Dylan sought out the experience of Randy S. Schwartzberg, M.D., a board certified orthopaedic surgeon specializing in sports medicine, knee, elbow and shoulder surgery at Orlando Orthopaedic Center.
“Dylan had sustained an anterior shoulder dislocation event, meaning the head of the humerus (ball of the ball and socket joint) came out the front of the shoulder joint,” says Dr. Schwartzberg. “When a young football player sustains an anterior shoulder dislocation, the likelihood of it recurring is extremely high. Studies show that the likelihood of recurrent shoulder dislocations in young male collision sport athletes approximates 90%.”
Together, Dylan and Dr. Schwartzberg decided that surgery was his best option to decrease his risk of recurrent dislocation and to give him the best chance to get back on the field.
“My brother had the surgery already, and he’s playing college football,” says Dylan. “So obviously, you can keep playing after you’ve had the surgery.”
Based on his extensive experience treating athletes of all ages, Dr. Schwartzberg knew exactly how to proceed.
“Because of the very high recurrent redislocation rate, we recommend a minimally invasive arthroscopic surgery termed a Bankart repair to fix that problem in a young athlete,” he says. “During the procedure, I repaired the torn labrum that occurred as a result of the shoulder dislocation.”
What is Arthroscopic Bankart Repair?
An arthroscopic Bankart repair is a surgical procedure to restore the damaged and altered anatomy resulting from a traumatic anterior shoulder dislocation. The bony anatomy of the shoulder joint includes the head of the humerus (the ball) and the glenoid (the socket). Because the socket is rather shallow, it does not allow for a strong fit for the ball, meaning other structures are necessary to enhance the stability of the joint. The labrum, made of something called fibrocartilage, is a strong rim of tissue that surrounds the glenoid (socket) and attaches to it firmly. There are also important ligaments making up the capsule of the shoulder that attach to the head of the humerus to the glenoid.
When the arm is forced into a direction causing the humeral head to forcefully move to the front (anterior) part of the body, the labrum can tear away from the anterior portion of the glenoid. When that happens, the ligaments attaching to this anterior labrum become lax. Since the labrum does not typically heal properly, this anterior labral tear, called a Bankart lesion, predisposes an athlete to recurrent shoulder dislocations. The result of the Bankart lesion is an unstable shoulder, and this was the concern with Dylan’s injury.
The arthroscopic Bankart repair surgery begins when Dr. Schwartzberg inserts a small diameter highly specialized camera (an arthroscope) into the shoulder through a very small incision. This camera allows the procedure to be viewed on a large high definition flat screen monitor. Several very small incisions/portals are created to allow specialized instruments to be placed into the shoulder to facilitate the surgical repair in a minimally invasive fashion.
The torn anterior labrum (Bankart lesion) is reattached to the bony glenoid with specialized implants called suture anchors. These are small diameter bioabsorbable devices that are placed into the glenoid after Dr. Schwartzberg drills small and precise holes to accommodate them. The anchors have sutures attached to them that can be passed through the torn labrum with specialized instruments. This allows the torn labrum to be securely reattached to the glenoid by tying arthroscopic knots or via an interference fit with the sutures, ultimately restoring the anatomy and stability to the shoulder joint in the most minimally invasive manner available.
Results and Effectiveness of Arthroscopic Bankart Repair
Medical studies have shown arthroscopic Bankart repair is a highly successful surgical procedure. The procedure can provide excellent clinical outcomes, normal shoulder mobility and low recurrent dislocation rates.
“Dylan was able to return to football successfully four months after the surgery,” says Dr. Schwartzberg. “He made it just in time for the playoffs and led the Dr. Phillips High School team in tackles on the way to their state championship game appearance. Once the high school football season ended, Dylan capped off his dominant wrestling career with his third consecutive state championship title.”
Dylan says he is immensely thankful for Dr. Schwartzberg and the team at Orlando Orthopaedic Center. In fact, he says he barely noticed he had the surgery most days.
“I don’t notice that there’s anything wrong with my shoulder during the games until I come off (the field),” says Dylan. “I realize, ‘Oh yeah, I’ve got a brace to take off before I can take my pads off.’ That’s the only issue I’ve had with the whole surgery.”
Dylan also appreciated Dr. Schwartzberg’s candid and honest approach. “The thing I really love about Dr. Schwartzberg, and I went to a doctor to get another recommendation when I was going for my surgery, is he’s going to tell you the truth.”
“Some doctors say you need to stay out eight months with this and try and make it seem like you’re never going to play football again,” he says, “but Dr. Schwartzberg is going to tell you the truth, show you the research for it, and he’s not going to lie to you.”