Techniques in Arthroscopic Rotator Cuff Repair: Single-Row Repair: The Preferred Approach

Several arthroscopic methods of tendon-bone repair have been studied extensively, and controversy remains over the preferred choice of fixation. Single-row constructs, traditionally repaired with anchors placed in a linear manner from anterior to posterior on the greater tuberosity, offer excellent clinical results. To date, sufficient evidence does not exist proving double-row rotator cuff repair will result in superior clinical outcomes to single-row repair, particularly to justify the increased cost and operative time. Multiple systematic reviews have been conducted comparing both double-row and single-row repairs addressing subjective and objective results. These reviews conclude that despite improved structural healing, there is no statistically significant difference in patient outcomes between single-row and double-row rotator cuff repairs. Tissue strangulation, tension-mismatch repairs, the potential for type 2 retears, and unfavorable cost analyses are all additionally relevant issues questioning double-row constructs. Therefore, a well-performed single-row repair using 3 sutures per anchor with reduced lateral traction on the detached tendon will provide a favorable outcome, at reasonable expense, in most patients with a rotator cuff tear.
Source: Techniques in Shoulder and Elbow Surgery - Category: Orthopaedics Tags: Hot Topics and Controversies Source Type: research