Shoulder
Single-row versus double-row arthroscopic rotator cuff repair in small- to medium-sized tears

https://doi.org/10.1016/j.jse.2009.11.053Get rights and content

Hypothesis

Double-row rotator cuff repair leads to superior cuff integrity and clinical results compared with single-row repair.

Materials and methods

The study enrolled 68 patients with a full-thickness rotator cuff tear who were divided into 2 groups of 34 patients according to repair technique. The patients were followed-up for at least 2 years. The results were evaluated by Constant score.

Discussion

Despite the biomechanical studies and cadaver studies that proved the superiority of double-row fixation over single-row fixation, our clinical results show no difference in functional outcome between the two methods. It is evident that double-row repair is more technically demanding, expensive, and time-consuming than single-row repair, without providing a significant improvement in clinical results.

Results

Comparison between groups did not show significant differences. At the final follow-up, the Constant score was 82.2 in the single-row group and 78.8 in the double-row group. Functional outcome was improved in both groups after surgery, but the difference between the 2 groups was not significant.

Conclusions

At long-term follow-up, arthroscopic rotator cuff repair with the double-row technique showed no significant difference in clinical outcome compared with single-row repair in small to medium tears.

Section snippets

Materials and methods

This prospective, randomized study enrolled 68 patients with a full-thickness rotator cuff tear. The patients provided informed consent to their data being included in the study. The inclusion criteria included a full-thickness tear as seen on magnetic resonance imaging (MRI), willingness to comply with a standardized rotator cuff physical therapy program, and a tear pattern that was amenable to repair with either single-row or double-row fixation when evaluated at the time of surgery.

The

Results

No patients were lost to follow-up, and all completed at least a 2-year evaluation. The average preoperative duration of symptoms for the study patients was 14 months (range, 2 months-6 years). The mean follow-up was 36 months (range, 24-40 months). The patients were an average age of 58 years (range, 36-69 years) in the entire group, 59 (range, 40-69) in the single-row group, and 57 (range, 36-67 years) in the double-row group. The mean operation time was 87 minutes (range, 58-137 minutes) in

Discussion

The recent arthroscopic repair techniques for rotator cuff tears have emphasized the potential for a double-row repair to add strength to the repair and decrease the anatomic failure rate.1, 2, 9 One of the most common complications of arthroscopic rotator cuff repair is rerupture.3 Among the factors that have been investigated as predictors of durability of rotator cuff repair, primary fixation of tendon to bone is considered a success key of the procedure. Different suture techniques have

Conclusion

This prospective randomized evaluation of single-row compared with double-row rotator cuff fixation did not show a significant difference in outcome in terms of clinical results in small to medium tears.

Disclaimer

The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

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