Systematic Review
Clinical Outcomes of Double-Row Versus Single-Row Rotator Cuff Repairs

https://doi.org/10.1016/j.arthro.2009.08.009Get rights and content

Purpose

The purpose of this review was to determine whether there is a difference in the clinical outcome between single-row and double-row rotator cuff repairs.

Methods

We performed a systematic review of the results of clinical studies investigating and comparing double-row and single-row repair techniques. The articles meeting the inclusion and exclusion criteria were assessed for quality of the study; the results were then reviewed to provide a concise conclusion regarding the clinical outcomes of double-row versus single-row rotator cuff repair.

Results

There were 3 Level I studies and 2 Level II studies comparing the clinical outcomes of double-row and single-row rotator cuff repair. At 1-year follow-up, there was no statistically significant clinical difference between patients who had undergone double-row repair and those who had undergone single-row rotator cuff repair.

Conclusions

Arthroscopic rotator cuff repairs with double-row repair show no significant difference compared with single-row repair in clinical outcome at 1-year follow-up. Additional prospective, randomized controlled trials are needed with longer-term follow-up to determine whether there is any clinical difference between the 2 techniques.

Level of Evidence

Level II, systematic review of Level I and II studies.

Section snippets

Methods

A systematic review was performed to investigate the clinical outcomes of DR versus SR rotator cuff repair techniques. EMBASE, Cochrane Library, PubMed, and OVID were searched from their earliest points to August 1, 2009. The search terms “double-row and single-row and rotator cuff” were used. A total of 35 articles were identified with this search. A hand search of the last 6 months of issues of appropriate journals was performed, including the Journal of Bone and Joint Surgery (American and

Results

The data from the 5 prospective studies were collected and summarized (Table 1). The outcome measures varied between studies, although 4 of 5 used the Constant score as a functional assessment. The use of an imaging modality postoperatively was not an inclusion criterion of the review; however, it is noted that 3 of the 5 studies included this outcome measure to evaluate postoperative healing in addition to clinical evaluation.

One Level II prospective cohort study, conducted by Charousset et

Discussion

This systematic review of the clinical evidence to date shows no clinically significant difference between SR and DR rotator cuff repair techniques. Only 5 Level I or Level II studies have been published to date. Both techniques result in significant clinical improvement for patients, but there was no statistically significant clinical difference between the 2 approaches. At short-term follow-up with a minimum of at least 1 year, clinical outcomes for both the DR and SR arthroscopic rotator

Conclusions

This systematic review of arthroscopic repair of rotator cuff tears shows that DR repair does not result in significantly different clinical outcomes than SR repair, at least in the short term. Although numerous biomechanical studies have shown that the DR repair technique provides a significantly improved repair with regard to strength, gap formation, failure, and re-creation of the anatomic footprint,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 this advantage does not appear to lead to an

Acknowledgment

The authors acknowledge Jack Carlisle, M.D., and Rick Wright, M.D., for their contributions in the preparation of this review.

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  • Cited by (0)

    The authors report no conflict of interest.

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