Comparative analysis of single-row versus double-row repair of rotator cuff tears

Abstract

Purpose: Our goal in this analysis was to compare clinical outcomes and radiographic healing rates of double-row (DR) transosseous-equivalent versus single-row (SR) Mason-Allen configuration (MAC) arthroscopic repair techniques.

Methods: A prospective, nonrandomized assessment of 132 arthroscopic rotator cuff repair patients included 78 SR repair patients and 54 with DR repair. Tears measured between 1.5 and 4.5 cm. Patients were evaluated with a visual analog scale; University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; active range of motion; and dynamometric strength. Scores and measurements were obtained preoperatively and at 3, 6, 12, and 24 months postoperatively. The SR repairs were performed with the arthroscopic MAC. For DR repairs, two 5.5-mm fully threaded Bio-Corkscrew anchors (Arthrex, Naples, FL), single loaded with FiberWire (Arthrex), were used for the medial row. The lateral row was secured with PushLock bioabsorbable anchors (Arthrex). Forty-four patients in the SR group and 37 patients in the DR group returned for magnetic resonance imaging (MRI) evaluation of repair integrity between 12 and 28 months postoperatively.

Results: DR repairs resulted in higher outcome scores, though not significantly. Patient satisfaction rates were 95% in the SR group and 92% in the DR group. MRI showed a statistically significantly improved healing rate with SR repair compared with DR repair in our entire patient population (P ≤ .017). A more homogeneous subset of patients with tears between 2.5 and 3.5 cm showed a significantly improved healing rate for the DR repair (P ≤ .03).

Conclusions: Our short-term results suggest that SR MAC repair provides comparable clinical results to DR repair. Although our MRI data suggest improved healing rates in our SR repairs in the entire patient population, when similar-sized tears were compared, the DR repair group showed improved radiographic healing.

Level of evidence: Level III, retrospective comparative study.