Evidence Based Rehabilitation Following Arthroscopic Bankart Repair with Remplissage for Recurrent Anterior Shoulder Instability: A Case Report

Dr. Srishti Shetty, Dr. Karishma Kapur Rattra

Abstract: Background: Bankart lesions are among the most common injuries associated with traumatic anterior shoulder instability and are frequently accompanied by other shoulder pathologies, including Hill-Sachs lesions, SLAP tears, synovitis, loose bodies, calcific tendinitis, and subacromial impingement. While arthroscopic Bankart repair combined with remplissage is widely used to restore shoulder stability, surgery alone is not sufficient to achieve optimal functional recovery. A carefully planned rehabilitation programme is essential to restore mobility, muscle strength, neuromuscular control, and confidence in everyday shoulder function. Case Presentation: A 57-year-old male presented to the physiotherapy outpatient department 12 days after arthroscopic Bankart repair with remplissage for a left shoulder SLAP tear with recurrent anterior shoulder instability. The patient reported pain during end-range shoulder movement, restricted range of motion, reduced rotator cuff strength, apprehension during shoulder movement, and difficulty in activities of daily living. Intervention: The patient participated in a structured, phase-based physiotherapy rehabilitation programme that was progressively advanced in accordance with tissue healing and functional recovery. During the early postoperative phase, rehabilitation focused on protecting the surgical repair while minimizing pain, maintaining joint mobility, and preventing muscle atrophy. Treatment included Pain Neuroscience Education, Blood Flow Restriction Training, pendulum exercises, passive-assisted shoulder range-of-motion exercises, scapular muscle activation, submaximal isometric strengthening, distal upper-limb mobility exercises, and a prescribed home exercise programme. As the patient's condition improved, the rehabilitation programme progressed to active range-of-motion exercises, graded exposure to previously apprehensive movements, rhythmic stabilization, proprioceptive and neuromuscular training, progressive strengthening, proprioceptive neuromuscular facilitation (PNF) patterns, closed kinetic chain exercises, and task-specific functional training to facilitate a safe return to daily activities. Outcome: Following two weeks of supervised rehabilitation, the patient demonstrated meaningful improvements across multiple clinical outcomes. Pain during end-range shoulder movement decreased from 6/10 to 1/10 on the Numerical Pain Rating Scale. Active shoulder flexion improved substantially from 45? to 145?, while manual muscle testing showed an increase in both internal and external rotator strength from Grade 3/5 to Grade 4/5. In addition to these objective gains, the patient exhibited improved scapulohumeral rhythm, greater confidence during shoulder movement with reduced apprehension, and enhanced independence in performing activities of daily living. Conclusion: This case report highlights the potential value of a structured, individualized physiotherapy rehabilitation programme following arthroscopic Bankart repair with remplissage. Combining conventional rehabilitation strategies with contemporary interventions such as Pain Neuroscience. Education, Blood Flow Restriction Training, scapular stabilization, neuromuscular re-education, proprioceptive exercises, and progressive strengthening was associated with early improvements in pain, shoulder mobility, muscle strength, and functional performance. These findings reinforce the importance of a carefully progressed rehabilitation programme in supporting safe and effective recovery after shoulder stabilization surgery.

Keywords: Bankart lesion, arthroscopic Bankart repair, remplissage, physiotherapy, shoulder instability, Blood Flow Restriction Training, Pain Neuroscience Education, case report

How to Cite?: Dr. Srishti Shetty, Dr. Karishma Kapur Rattra, "Evidence Based Rehabilitation Following Arthroscopic Bankart Repair with Remplissage for Recurrent Anterior Shoulder Instability: A Case Report", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 189-195, https://www.ijsr.net/getabstract.php?paperid=SR26716151200, DOI: https://dx.doi.org/10.21275/SR26716151200

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