Prospective Randomized Clinical Trial of Single- Versus Double-Row Suture Anchor Repair in 2- to 4-cm Rotator Cuff Tears: Clinical and Magnetic Resonance Imaging Results

doi:10.1016/j.arthro.2010.11.059

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Volume 27, Issue 4, April 2011, Pages 453-462

Presented at the 2009 Annual Meeting of the Arthroscopy Association of North America, San Diego, CA, April 2009.

https://doi.org/10.1016/j.arthro.2010.11.059 Get rights and content

Purpose

The purpose of this study was to compare the clinical outcomes and the retear rates of arthroscopic single-row (SR) and double-row (DR) suture anchor repair in 2- to 4-cm rotator cuff tears.

Methods

From 2005 to 2007, 71 patients with a 2- to 4-cm rotator cuff tear (proven by arthroscopy) were prospectively randomized to SR and DR repair groups. Of these patients, 62 (31 in each group) were available for evaluation at final follow-up. Demographic data, clinical scores, mean surgical times, and patient satisfaction were compared. Retear rates and clinical scores were also analyzed for 47 patients who underwent follow-up magnetic resonance imaging.

Results

Comparisons of demographic data, tear size on preoperative magnetic resonance imaging, global fatty degeneration index, and concomitant procedures showed no differences between the SR and DR groups. Preoperative clinical scores were significantly improved postoperatively in both groups. No intergroup differences in pain visual analog scale, American Shoulder and Elbow Surgeons, Constant, or University of California, Los Angeles scores were found at final follow-up. Only mean surgical time was significantly different between the 2 groups. In the SR group, there were 4 full-thickness retears and 11 partial-thickness retears, whereas in the DR group, there were 6 full-thickness retears and 1 partial-thickness retear. However, despite numerical differences, these differences were not statistically different. Statistically, there were no significant differences both in full-thickness retear (P = .999) and retear including partial-thickness tear between the 2 groups (P = .124).

Conclusions

This study indicates that the clinical results and retear rates of DR repair with 1 additional medial suture anchor were not significantly different from those of SR repairs with 2 lateral suture anchors in patients with medium to large rotator cuff tear.

Level of Evidence

Level I, randomized controlled trial.

Section snippets

Patient Selection and Randomization

Inclusion criteria for this study were (1) a full-thickness rotator cuff tear proven by preoperative magnetic resonance imaging (MRI) or magnetic resonance arthrography, (2) symptoms lasting more than 6 months with proper conservative treatment, and (3) a 2- to 4-cm tear size in either the coronal or sagittal plane, which was measured and confirmed intraoperatively. After debridement of pathologic tissue and preparation for repair, the tear size and inclusion were decided. Rotator cuff tears

Results

The mean age of the 62 study subjects was 61.3 years (range, 43 to 78 years). There were 20 men and 42 women. The right arm was dominant in 59 and the left in 3, and the right shoulder was involved in 43 and the left in 19. The mean time from symptom onset to surgery was 17.4 months (range, 6 to 84 months). The SR group was followed up for 31.0 months (range, 24 to 44 months) and the DR group for 32.8 months (range, 24 to 42 months). Distal clavicle resection was performed in 7 patients,

Discussion

The principal finding of this study was that there is no difference between SR and DR rotator cuff repairs in terms of clinical outcome at a mean of 31.9 months after surgery. Furthermore, retear rates were not different between the 2 study groups. Especially in comparison of retear rate between the SR and DR groups, full-thickness retear was observed in 4 of 24 patients (16.7%) and 6 of 23 patients (26.1%), respectively, and there was no statistically significant difference. On the basis of

Conclusions

This study showed that DR repair with 1 additional medial suture anchor and 2 added stitches for rotator cuff repair produced no difference in terms of clinical outcome or retear rate compared with SR repair for medium to large (2- to 4-cm) rotator cuff tears.

Acknowledgment

The authors give special thanks to Hang Seok Choi for the statistical analysis.

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To compare the double row technique versus the single row technique for arthroscopic rotator cuff repair, in order to assess whether there are clinical differences.
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: Supported by a grant from the Samsung Medical Center Clinical Research Development Program (No. CRS-109-11-1).

: The authors report no conflict of interest.

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Original ArticleProspective Randomized Clinical Trial of Single- Versus Double-Row Suture Anchor Repair in 2- to 4-cm Rotator Cuff Tears: Clinical and Magnetic Resonance Imaging Results

Purpose

Methods

Results

Conclusions

Level of Evidence

Section snippets

Patient Selection and Randomization

Results

Discussion

Conclusions

Acknowledgment

Arthroscopy

J Shoulder Elbow Surg

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

J Shoulder Elbow Surg

J Shoulder Elbow Surg

J Shoulder Elbow Surg

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopic repair of full-thickness tears of the supraspinatus: Does the tendon really heal?

J Bone Joint Surg Am

The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears

J Bone Joint Surg Am

The results of repair of massive tears of the rotator cuff

J Bone Joint Surg Am

Arthroscopic rotator cuff repair: A multicentric retrospective study of 87 cases with anatomical assessment

Rev Chir Orthop Reparatrice Appar Mot

Repairs of the rotator cuffCorrelation of functional results with integrity of the cuff

J Bone Joint Surg Am

Original Article
Prospective Randomized Clinical Trial of Single- Versus Double-Row Suture Anchor Repair in 2- to 4-cm Rotator Cuff Tears: Clinical and Magnetic Resonance Imaging Results