Summary of Meta-Analyses Dealing with Single-Row versus Double-Row Repair Techniques for Rotator Cuff Tears

Abstract

Background:Several meta-analyses of randomized clinical trials have been performed to analyze whether double-row (DR) rotator cuff repair (RCR) provides superior clinical outcomes and structural healing compared to single-row (SR) repair. The purpose of this study was to sum up the results of meta-analysis comparing SR and DR repair with respect on clinical outcomes and re-tear rates.Methods:A literature search was undertaken to identify all meta-analyses dealing with randomized controlled trials comparing clinical und structural outcomes after SR versus DR RCR.Results:Eight meta-analyses met the eligibility criteria: two including Level I studies only, five including both Level I and Level II studies, and one including additional Level III studies. Four meta-analyses found no differences between SR and DR RCR for patient outcomes, whereas four favored DR RCR for tears greater than 3 cm. Two meta-analyses found no structural healing differences between SR and DR RCR, whereas six found DR repair to be superior for tears greater than 3 cm tears.Conclusion:No clinical differences are seen between single-row and double-row repair for small and medium rotator cuff tears after a short-term follow-up period with a higher re-tear rate following single-row repairs. There seems to be a trend to superior results with double-row repair in large to massive tear sizes.

All-Suture Repair for Compressive Rotator Cuff Tears: Reducing the Traction of the Tissue

“…6 In addition, it gives a better biomechanical result to that obtained with the single row. 5 In this regard, the higher economic cost compared with single row might be the main disadvantage. Use the lateral portal and visioning portal for a frontal image of cuff tear that allows us to better diagnose and therefore better configure it for repair.…”

“…4,7 In this context, this suture bridge allows us to achieve a greater contact surface between the torn cuff and the humeral footprint if we compare it with that obtainable from a suture with simple knots, a circumstance that would be more of an advantage to get a good result. 4,5 Similarly, the use of knots allows for control of the traction exercised on the torn tendon at all times. Thus, the phenomenon of tendon tearing is prevented.…”

“…Single-row or double-row systems, sutures with simple knots, or the so-called knotless or suture bridge are used. 4 The controversy lies in that these different suturing systems have their advantages and disadvantages 4,5 and there is still no single suture system that has all the conditions in its favor to be called the most favored.…”

Rotator Cuff Tears : Short- and long-term aspects on treatment outcome

“…In order to achieve a more stable compression and wider contact area of the tendon against bone, a double row of suture anchors has been proposed by Lo and Burkhart 168 . Double-row repair may have a lower retear rate compared to single-row repair 119 , but for small and medium sized tears there seem to be no difference in clinical outcome 247 . Knotless anchor is an alternative, where the thread is fixed to bone after having been passed through the tendon.…”

Rotator Manşet Yırtığı Onarımı İçin Çift Sıra Tamir Tekniği Yerine Tek Sıra Tamir Tekniği Kullanılarak Başarılı Sonuçlar Elde Edilebilir Mi?

“…With the technological improvements in arthroscopic instruments, arthroscopic repair has been increasingly used over the open technique for repair of the rotator cuff tear. [1][2][3][4] To date, however, no consensus has been established about the preferred technique for rotator cuff tendon tears. [4][5][6][7] Biomechanical studies have shown that the double-row repair technique is superior to the single-row repair technique in the extent of footprint coverage, strength of the repaired tendon, gap formation, pressure under the repaired tendon, and the number of cycles to failure, and to date, no clinical diff erences have been observed between the double-and single-row repair techniques.…”