Clinical Outcome and Imaging of Arthroscopic Single-Row and Double-Row Rotator Cuff Repair: A Prospective Randomized Trial

• Published in: Arthroscopy Vol. 28; no. 1; pp. 16 - 24
• Main Authors: Ma, Hsiao-Li, M.D, Chiang, En-Rung, M.D, Wu, Hung-Ta H., M.D, Hung, Shih-Chieh, M.D., Ph.D, Wang, Shih-Tein, M.D, Liu, Chien-Lin, M.D, Chen, Tain-Hsiung, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Aortography; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Diseases of the osteoarticular system; Endoscopy; Female; Follow-Up Studies; Humans; Injury Severity Score; Investigative techniques, diagnostic techniques (general aspects); Juxtaarticular diseases. Extraarticular rhumatism; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Orthopedic surgery; Orthopedics; Prospective Studies; Range of Motion, Articular - physiology; Recovery of Function; Reference Values; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder - surgery; Shoulder Injuries; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Suture Anchors; Suture Techniques; Tendon Injuries - diagnosis; Tendon Injuries - surgery; Time Factors; Treatment Outcome; Juxtaarticular disease; Arthroscopy; Orthopedic surgery; Prognosis; Treatment; Rotator cuff rupture; Diseases of the osteoarticular system; Endoscopy
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2011.07.003

Purpose The purpose of this study was to compare the clinical and imaging outcomes of single-row and double-row suture anchor fixation in arthroscopic rotator cuff repair with emphasis on analysis of the effect of various tear size on repair integrity. Methods Fifty-three patents were randomized to either single-row or double-row rotator cuff repair at the time of surgical intervention. The clinical results were evaluated by applying the UCLA score and the ASES index and assessing muscle strength in abduction and external rotation with a minimum 2-year follow-up. The postoperative rotator cuff integrity was evaluated by magnetic resonance arthrography at 6-month and minimum 2-year follow-up. Results We enrolled 27 patients in the single-row group and 26 patients in the double-row group. Statistically, the UCLA score; the ASES index; and muscle strength were significantly increased in both groups after surgery, but there was no significant difference between the 2 groups. At minimum 2-year follow-up, intact rotator cuffs were found in 17 patients in the single-row group and 20 in the double-row group, based on magnetic resonance arthrography results. Overall, there was no significant difference in postoperative structural integrity between the 2 groups at 6-month and 2-year follow-up. In patients with tear size larger than 3 cm, the muscle strength of the shoulder was significantly better in the double-row group. For the final imaging results, regardless of the tear size, there was no difference between the single-row and double-row groups. Conclusions Arthroscopic rotator cuff repair with double-row fixation showed better shoulder strength in patients with larger tear size (>3 cm) in comparison with single-row fixation. However, the imaging results showed no significant difference in cuff integrity in both groups in patients with any tear size at 6-month and minimum 2-year follow-up. Level of Evidence Level II, lesser-quality randomized control trial.