Single-Row Versus Double-Row Arthroscopic Rotator Cuff Repair: A Prospective Randomized Clinical Study (SS-26)

Abstract

The aim of this study was to compare the outcome of arthroscopic rotator cuff repair with single-row and double-row technique in a prospective randomized study. Eighty patients with a full-thickness rotator cuff tear underwent an arthroscopic repair with suture anchors. They were divided in two groups of 40 patients each, according to repair technique. Results were evaluated using the Constant score, and the DASH and Work-DASH questionnaires. At two-year follow-up, double-row repair showed slightly better clinical outcome than single-row repair, although the difference was not significant. To compare the clinical outcome of arthroscopic repair of full-thickness rotator cuff tears with single-row and double-row technique in a prospective randomized study. Eighty patients with a full-thickness tear of the posterior-superior rotator cuff underwent an arthroscopic repair with metal suture anchors. They were divided in two groups of 40 patients each, according to repair technique: single-row technique in group 1, and double-row technique in group 2. Exclusion criteria were: partial-thickness and irreparable cuff tears, subscapularis tears, labral pathology, os acromiale, degenerative arthritis of glenohumeral joint, symptomatic arthritis of acromioclavicular joint, rotator cuff arthropathy, previous surgery to the same shoulder, and workers' compensation claims. Results were evaluated using the Constant score normalized for age and gender, and the DASH and Work-DASH self-administered questionnaires. On analyzing the results at a two-year follow-up, we considered the following independent variables: age, gender, dominance, location, shape, and area of cuff tear, tendon retraction, fatty degeneration of cuff muscles, treatment of the biceps tendon, and rotator cuff repair technique. Univariate and multivariate statistical analysis were performed in order to find out variables that were independently associated to the outcome. Significance was set at p < .05. The null hypothesis was that differences between the two groups at the clinical outcome were not significant. Eight patients (10%) were lost at follow-up: 3 in group 1 and 5 in group 2. Comparison between groups did not show significant differences for each variable considered. Overall results for Constant score were 100.5 points in group 1 and 104.9 points in group 2; for DASH score were 15.4 points in group 1 and 12.7 points in group 2; for Work-DASH score were 16.0 points in group 1 and 9.6 points in group 2. Univariate and multivariate analysis showed that only age and gender significantly and independently influenced the outcome. Differences between groups 1 and 2 were not significant for each scoring system considered. Therefore, the null hypothesis was not rejected. At a short-term follow-up, arthroscopic repair of rotator cuff tears with double-row technique showed slightly better clinical outcome than single-row repair, although the difference was not significant.