Incidence of Retear With Double-Row Versus Single-Row Rotator Cuff Repair

Abstract

Rotator cuff tears have a high recurrence rate, even after arthroscopic rotator cuff repair. Although some biomechanical evidence suggests the superiority of the double-row vs the single-row technique, clinical findings regarding these methods have been controversial. The purpose of this study was to determine whether the double-row repair method results in a lower incidence of recurrent tearing compared with the single-row method. Electronic databases were systematically searched to identify reports of randomized, controlled trials (RCTs) comparing single-row with double-row rotator cuff repair. The primary outcome assessed was retear of the repaired cuff. Secondary outcome measures were the American Shoulder and Elbow Surgeons (ASES) shoulder score, the Constant shoulder score, and the University of California, Los Angeles (UCLA) score. Heterogeneity between the included studies was assessed. Six studies involving 428 patients were included in the review. Compared with single-row repair, double-row repair demonstrated a lower retear incidence (risk ratio [RR]=1.71 [95% confidence interval (CI), 1.18-2.49]; P=.005; I(2)=0%) and a reduced incidence of partial-thickness retears (RR=2.16 [95% CI, 1.26-3.71]; P=.005; I(2)=26%). Functional ASES, Constant, and UCLA scores showed no difference between single- and double-row cuff repairs. Use of the double-row technique decreased the incidence of retears, especially partial-thickness retears, compared with the single-row technique. The functional outcome was not significantly different between the 2 techniques. To improve the structural outcome of the repaired rotator cuff, surgeons should use the double-row technique. However, further long-term RCTs on this topic are needed.

Proximal Rectus Femoris Avulsion Repair

“…However, the body of literature regarding rotator cuff repairs is significantly broader, and therefore, we can infer that similar results for this technique may be possible, such as a potentially higher rate of tendon healing, 11 in addition to the possibility of performing accelerated postoperative rehabilitation in a safer manner with a double-row technique 12 because of the added strength 13,14 and a decreased incidence of retears. 13 However, this has yet to be validated in rectus femoris repairs. Moreover, we acknowledge that the surgical time can be increased because the procedure is more technically demanding and the cost is elevated because more anchors are used.…”

Arthroscopic rotator cuff repair: single-row vs. double-row – clinical results after one to four years

“…In addition to its superiority in the laboratory, the literature has already demonstrated lower rates of in vivo re-rupture with the use of the new technique. 8 Nonetheless, there is no consensus regarding its superiority in functional results. In a magnetic resonance study, Tudisco et al 5 observed lower rates of re-rupture with the use of DR, but those authors did not observe clinical differences between the patients operated by that technique and those who underwent SR fixation.…”

The Management of large and massive rotator cuff tears- Current trends amongst UK shoulder surgeons

“…Notably the majority of surgeons would still choose to operate in the younger age groups despite a belief that the repair would fail within 1-2 years. This is signifi cant since it demonstrates that surgeons are undertaking surgery which they accept will fail in a fairly short time scale, possibly refl ecting reports that in general symptoms do not necessarily follow recurrence [50]. However, we would argue that the scenario of a rigorous There are limitations to this study.…”