Can a Double-Row Anchorage Technique Improve Tendon Healing in Arthroscopic Rotator Cuff Repair?

Charousset, Christophe; Grimberg, Jean; Duranthon, L.-D.; Bellaïche, L.; Petrover, David

doi:10.1177/0363546507301661

Cited by 200 publications

(80 citation statements)

References 29 publications

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“…In contrast, Park et al [48] reported that in patients with large to massive tears (> 3 cm), the American Shoulder and Elbow Surgeons Score, Constant scores and Shoulder Strength Index were all significantly better in the group that had double-row repair. Despite the fact that most studies have failed to demonstrate clinical differences with singe vs double row repairs at short term follow-up, there appears to be a lower re-tear rate for the double-row compared with the single-row repairs [49][50][51] . Lapner et al [49] , in a multicenter randomized controlled trial comparing single-row with double-row fixation in arthroscopic rotator cuff repairs reported that although doublerow fixation was associated with higher healing rates, no significant differences in functional or quality-oflife outcomes were identified between single-row and double-row fixation techniques.…”

Section: Muscle-tendon Unit Retractionmentioning

confidence: 88%

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

159

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Rotator cuff repair has been shown to have good longterm results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. Core tip: Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscletendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing after rotator cuff repair. Smoking cessation and blood glucose and cholesterol control are methods to potentially improve healing rates. Slower, less aggressive rehabilitation programs may improve healing rates with no negative effect on final range of motion and are therefore recommended after arthroscopic repair of most full thickness tears. Finally, no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates after rotator cuff repair. Routine use of these adjuvants is therefore not currently recommended.

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Section: Muscle-tendon Unit Retractionmentioning

confidence: 88%

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

159

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“…Charousset et al [5] conducted a non-randomised comparative study including 31 patients in the double-row group and 35 in the single-row group. No significant differences were found regarding clinical outcomes measured by the Constant scale with a follow-up of approximately 28 months.…”

Section: Discussionmentioning

confidence: 99%

“…However, the technique using a double row of anchors is reported to re-establish the normal rotator cuff footprint and increase the contact area for healing [8,13,23] making the anatomical and biomechanical outcomes are better than with the single-row technique [3,6,15,18]. Although a few studies have compared single-row repair and double-row repair with regard to clinical aspects [5,7,17,19,21,24], no articles have been published that support the superior clinical outcomes of double-row fixation over single-row fixation. This prospective randomised clinical trial was performed to address the question of whether a double-row rotator cuff anchor repair gives results superior to a single-row anchor repair in clinical outcome scores and in magnetic resonance imaging (MRI) evaluation.…”

Section: Introductionmentioning

confidence: 99%

Single-row versus double-row arthroscopic repair in the treatment of rotator cuff tears: a prospective randomized clinical study

Carbonel

Martı́nez

Calvo

et al. 2012

International Orthopaedics (SICOT)

111

121

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Purpose The purpose of this study was to compare arthroscopic rotator cuff repair with single-row and double-row techniques because research has demonstrated the superiority of double-row repair from a biological and mechanical point of view but there is no evidence of clinical superiority. Methods A total of 160 patients with a full-thickness rotator cuff tear underwent arthroscopic repair with suture anchors. They were randomised into two groups of 80 patients according to the repair technique: single-row (group 1) and double-row (group 2). Results were evaluated by use of the University of California, Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES) and Constant questionnaires, the Shoulder Strength Index (SSI) and range of motion. Follow-up time was two years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and two years after repair. Results One hundred per cent of the patients were followed up. All measurements showed significant improvement compared with the preoperative status. The UCLA score showed significant improvement in group 2. In over 30-mm tears UCLA and ASES showed significant differences. SSI showed significant improvement in group 2. Range of motion showed significant improvements in flexion and abduction in group 2. In under 30-mm tears group 2 showed also significant improvement in internal and external rotation. In MRI studies there were no significant differences.Conclusions At two years follow-up the double-row repair technique showed a significant difference in clinical outcome compared with single-row repair and this was even more significative in over 30-mm tears. No MRI differences were observed.

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“…8 Charousset et al also found no significant difference in clinical results; but, anatomic tendon healing rates were better with the double row repairs based on computed tomographic (CT) arthrography. 13 Several tears 3 cm were repaired using a double row technique, they had better American Shoulder and Elbow Surgeons (ASES) and Constant scores postoperatively as compared to single row repairs. This was the first study to show a clinical difference between single and double row repairs, and it was strictly in these larger sized tears.…”

Section: Clinical Datamentioning

confidence: 99%