Arthroscopy: The Journal of Arthroscopic & Related Surgery
Meta-analysisSingle-Row Repair Versus Double-Row Repair of Full-Thickness Rotator Cuff Tears
Section snippets
Methods
Using MEDLINE, SCOPUS, SCIRUS, CINAHL, and the Cochrane library, as well as a hand search, we searched for articles that were published before September 2009. The search terms “single-row” and “double-row” were used. Inclusion criteria included controlled clinical trials, quasi-randomized controlled trials, and randomized controlled trials that compared the results of single-row rotator cuff repair with the results of double-row rotator cuff repair. All double-row repair techniques, described
Results
Six clinical trials comparing the outcomes of single-row and double-row repair were identified. One study, conducted by Brady et al.,19 was excluded because of its retrospective design. Thus 5 studies met our criteria and were included and assessed for methodologic quality. Two studies (Charousset et al.20 and Park et al.21) had a cohort design, and three (Burks et al.,22 Franceschi et al.,23 and Grasso et al.24) were randomized controlled trials. The details of these studies are shown in Table
Discussion
The goal of rotator cuff repair is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading, and optimize the biological healing of the tendon-bone interface. Many surgical techniques have been developed to achieve these goals. Transosseous repairs are shown to have the highest ultimate load resistance and the lowest gap formation.13 Double-row repairs, especially using a “transosseous-equivalent technique,” are designed to achieve
Conclusions
Despite the fact that double-row repair shows a significantly higher rate of tendon healing and greater external rotation than does single-row repair, there is no significant improvement in shoulder function, muscle strength, forward flexion, internal rotation, patient satisfaction, or return to work.
References (24)
- et al.
Arthro-C-scan analysis of rotator cuff tears healing after arthroscopic repair: Analysis of predictive factors in a consecutive series of 167 arthroscopic repairs
Rev Chir Orthop Reparatrice Appar Mot
(2006) - et al.
Arthroscopically assisted rotator cuff repair: Correlation of functional results with integrity of the cuff
Arthroscopy
(1994) - et al.
Double-row arthroscopic rotator cuff repair: Re-establishing the footprint of the rotator cuff
Arthroscopy
(2003) - et al.
Rotator cuff repair: The effect of double-row fixation on three-dimensional repair site
J Shoulder Elbow Surg
(2006) - et al.
Rotator cuff tears: The effect of the reconstruction method on three-dimensional repair site area
Arthroscopy
(2002) - et al.
Mini-open rotator cuff repair using a two-row fixation technique: Outcomes analysis in patients with small, moderate, and large rotator cuff tears
Arthroscopy
(2002) Arthroscopic rotator cuff repair: Analysis of technique and results at 2- and 3-year follow-up
Arthroscopy
(1998)Technique of arthroscopic rotator cuff repair using implantable 4-mm Revo suture anchors, suture Shuttle Relays, and no. 2 nonabsorbable mattress sutures
Orthop Clin North Am
(1997)- et al.
Evaluation of residual rotator cuff defects after in vivo single- versus double-row rotator cuff repairs
Arthroscopy
(2006) - et al.
Single-row versus double-row arthroscopic rotator cuff repair: A prospective randomized clinical study
Arthroscopy
(2009)
Arthroscopic repair of full-thickness tears of the supraspinatus: Does the tendon really heal?
J Bone Joint Surg Am
Arthrography of the shoulder after operative repair of the torn rotator cuff
J Bone Joint Surg Br
Cited by (64)
Blended Suture-bridge Technique for Arthroscopic Rotator Cuff Repair
2023, Arthroscopy TechniquesThe High Resistance Loop (H-Loop) Technique for Arthroscopic Repair of Subscapularis
2023, Arthroscopy TechniquesTransosseous-Equivalent/Suture Bridge Arthroscopic Rotator Cuff Repair in Combination With Late Postoperative Mobilization Yield Optimal Outcomes and Retear Rate: A Network Meta-analysis of Randomized Controlled Trials
2022, Arthroscopy - Journal of Arthroscopic and Related SurgeryUpdate on all-arthroscopic vs. mini-open rotator cuff repair: A systematic review and meta-analysis
2021, Journal of OrthopaedicsTear characteristics and surgeon influence repair technique and suture anchor use in repair of superior-posterior rotator cuff tendon tears
2019, Journal of Shoulder and Elbow Surgery
The authors report no conflict of interest.