Bony Bankart 病変に対する　鏡視下重層固定法（DAFF）

抄録

Introduction: Recently, it has become possible to repair the bony Bankart region by an arthroscopic procedure.We report a new fixation technique (DAFF) for the bony Bankart region.
Material: The subjects were 14 males. In all cases, injury to the bony Bankart region was confirmed by CT examination. The average age at operation was 29 years old.The average follow-up period was 12 months. 1) The reduced position of the bony Bankart fragment was maintained by a modified TOTS method. 2) Medial anchor: A knotless anchor with 2 loops penetrated through the bony Bankart fragment at the scapular neck on the medial side. 3) Lateral anchor: The two loops were individually fixed to the edges of the scapular joint surface to form a V-shape using the knotless anchor. 4) If necessary, procedures 2) and 3) were repeated. 5) AW-shape was created by performing these procedures twice.
Results: All case achieved bone union as confirmed by CT.The mean pre- and post-operative JSS scores were 45 and 88, respectively, showing improvement. The average preoperative Rowe score was 20, while the average postoperative score was 82.
Discussion: The advantages of this procedure (DAFF) are as follows: (1) Anatomical repair of the Bankart region is possible. (2) Handling is easy because of the knotless anchor and method. (3) Special arthroscopic devices are not required. (4) Even when the bony fragment is large, it remains easy to insert the medial anchor. Conclusion Dual row fixation for bony Bankart lesion achieved good short-term results.