Functional and structural outcomes of single-row versus double-row versus combined double-row and suture-bridge repair for rotator cuff tears

• Published in: The American journal of sports medicine Vol. 39; no. 10; p. 2091
• Main Authors: Mihata, Teruhisa, Watanabe, Chisato, Fukunishi, Kunimoto, Ohue, Mutsumi, Tsujimura, Tomoyuki, Fujiwara, Kenta, Kinoshita, Mitsuo
• Format: Journal Article
• Language: English
• Published: United States 01.10.2011
• Subjects: Adult; Aged; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Orthopedic Procedures - methods; Prospective Studies; Recovery of Function; Recurrence; Retrospective Studies; Rotator Cuff - surgery; Rotator Cuff Injuries; Suture Techniques; Tendon Injuries - surgery; Treatment Outcome
• ISSN: 1552-3365
• DOI: 10.1177/0363546511415660

Although previous biomechanical research has demonstrated the superiority of the suture-bridge rotator cuff repair over double-row repair from a mechanical point of view, no articles have described the structural and functional outcomes of this type of procedure. The structural and functional outcomes after arthroscopic rotator cuff repair may be different between the single-row, double-row, and combined double-row and suture-bridge (compression double-row) techniques. Cohort study; Level of evidence, 3. There were 206 shoulders in 201 patients with full-thickness rotator cuff tears that underwent arthroscopic rotator cuff repair. Eleven patients were lost to follow-up. Sixty-five shoulders were repaired using the single-row, 23 shoulders using the double-row, and 107 shoulders using the compression double-row techniques. Clinical outcomes were evaluated at an average of 38.5 months (range, 24-74 months) after rotator cuff repair. Postoperative cuff integrity was determined using Sugaya's classification of magnetic resonance imaging (MRI). The retear rates after arthroscopic rotator cuff repair were 10.8%, 26.1%, and 4.7%, respectively, for the single-row, double-row, and compression double-row techniques. In the subcategory of large and massive rotator cuff tears, the retear rate in the compression double-row group (3 of 40 shoulders, 7.5%) was significantly less than those in the single-row group (5 of 8 shoulders, 62.5%, P < .001) and the double-row group (5 of 12 shoulders, 41.7%, P < .01). Postoperative clinical outcomes in patients with a retear were significantly lower than those in patients without a retear for all 3 techniques. The additional suture bridges decreased the retear rate for large and massive tears. The combination of the double-row and suture-bridge techniques, which had the lowest rate of postoperative retear, is an effective option for arthroscopic repair of the rotator cuff tendons because the postoperative functional outcome in patients with a retear is inferior to that without retear.