2017 ISAKOS Biennial Congress ePoster #2231

 

A Meta-Analysis Comparing Single-Row and Double-Row Repair Techniques in the Treatment of Rotator Cuff Tears

Caiqi Xu, MD, Shanghai CHINA
Jinzhong Zhao, MD, Shanghai CHINA

Department of Sports Medicine, Shanghai Sixth People's Hospital, Shanghai, CHINA

FDA Status Not Applicable

Summary

Double-row rotator cuff repair techniques have a significantly lower re-tear rate, higher ASES score and greater ROM of internal rotation than do single-row.

Abstract

Background

Rotator cuff tears are among the most common shoulder injuries and can be a source of persistent pain, disability, and decreased range of motion and strength. Several rotator cuff repair techniques have been developed and compared with different clinical outcomes. Our purpose was to conduct a meta-analysis of recently published studies to compare the clinical results of a double-row technique with the results of a single-row technique for different tear sizes.
Materials & Methods: A search was performed in the Medline, Embase and OVID databases. All randomized, quasi-randomized clinical trials that reported the outcome of single-row repair and double-row repair techniques were included in our meta-analysis. Two subgroups were set according to the tear size. The outcomes were the Constant Score, ASES (American Shoulder and Elbow Surgeons) Score, UCLA (University of California, Los Angeles) Score, re-tear rate, range of motion and muscle strength.

Results

We included 9 studies in this meta-analysis, five of which were randomized prospective. There was a statistically significant difference in favor of double-row repair for the overall ASES score, re-tear rate and internal rotation range of motion. In subgroup 2 (tear size >30 mm), double-row techniques produce better outcomes than do single-row. There were no statistically significant differences in the overall Constant score, UCLA score, external rotation, and forward elevation range of motion or muscle strength.

Discussion

Double-row rotator cuff repairs, using a “transosseous-equivalent technique,” have been designed to achieve an initial fixation strength that is comparable to that of open or mini-open transosseous repair. Several biomechanical studies comparing single-row and double-row repair show an increased load to failure, improved contact at the tendon-bone interface, and decreased gap formation.

Conclusion

Double-row rotator cuff repair techniques have a significantly lower re-tear rate, higher ASES score and greater ROM of internal rotation than do single-row. Especially in those rotator cuff tears with a size of greater than 30 mm, the double-row technique is recommended for repair.