Abstract
BackgroundArthroscopic rotator cuff surgery is an effective treatment for rotator cuff tears with the considered use of double-row repair techniques becoming popular in the last decade. We aim to compare the effects of double- and single-row arthroscopic rotator cuff repairs (ARCR) on repair integrity (RI) and acromiohumeral distance (AHD).MethodsIn this observational study, we retrospectively identified 98 patients with degenerative rotator cuff tear treated with arthroscopic rotator cuff repair between 2016 and 2019. We excluded 22 patients with partial-thickness tears, 15 with associated subscapularis or SLAP tears, 13 with massive tears, and 5 patients lost to follow-up; we included 43 patients who had ARCR for full-thickness cuff tear and clinical, radiologic follow-up. Of these 43 patients, 23 are grouped as double-row repair group (DRG) and 20 as single-row repair group (SRG). A minimum of 12 months after the surgery, bilateral shoulder MRIs were obtained. Contralateral shoulders without asymptomatic rotator cuff tears served as a control group (CG). The operating surgeon and two other surgeons experienced in arthroscopy blindly measured the AHD and determined the RI at the control MRIs in all groups. Functional assessments relied on UCLA and qDASH Scores.ResultsThe mean age was 57.89 (45–78) years, and the mean follow-up time was 28,65 (21–43) months. The mean AHD of the CG was 9.7 ± 0.96 mm, the preoperative AHD of DRG was 8.62 ± 1.45 mm, and SRG was 9.71 ± 0.95 mm. The postoperative mean AHD of DRG 9.61 ± 1.83 mm and SRG was 10.21 ± 1.97 mm. AHD differences between the preoperative and postoperative groups were significant (P=0.009). The increase of the AHD in the double-row group was significantly higher than the single-row group (P=0.004). There was a high correlation between the RI and DASH scores (P=0.005). RI did not correlate with the repair method (P=0.580).ConclusionAlthough double-row repairs can maintain greater AHD than single-row repairs in the clinical setting, this difference did not affect functional results. Regardless of the surgical intervention, functional results are favourable if RI is achieved.Level of evidenceLevel III, Retrospective Cohort Study
Highlights
Over the last two decades, surgeons have come to choose arthroscopic methods over open surgical procedures
Materials and methods We retrospectively identified patients with degenerative rotator cuff tear treated with arthroscopic rotator cuff repair and acromioplasty between the years 2016 and 2019 at a tertiary training and research hospital; ethical approval was waived by a local ethics committee in view of the retrospective nature of the study
When the differences between the postoperative and control group distances were analyzed by repair method, the increase in the acromiohumeral distance (AHD) in the double-row group was significantly higher than the single-row group (P=0.004)
Summary
Over the last two decades, surgeons have come to choose arthroscopic methods over open surgical procedures. It has been suggested that double-row sutures are more durable and related to reduced rates of re-rupture and superior clinical outcomes than single-row repairs, the most recent research has shown that there is no significant difference between the clinical outcomes and re-tear rates of the two repair methods [2, 4, 8]. We aim to compare the effects of double- and single-row arthroscopic rotator cuff repairs (ARCR) on repair integrity (RI) and acromiohumeral distance (AHD)
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