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Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Single-row versus double-row rotator cuff repair: techniques and outcomes
Joshua S Dines1, Asheesh Bedi, Neal S ElAttrache
1Hospital for Special Surgery, New York, NY, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|February 2, 2010
Summary
Double-row rotator cuff repair offers biomechanical advantages but clinical studies show no significant functional improvement over single-row repair. More research is needed to confirm benefits and justify costs.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Sports Medicine
Background:
- Double-row rotator cuff repair utilizes medial and lateral suture anchors.
- Biomechanical studies suggest enhanced load to failure and healing enthesis contact for double-row repairs.
Purpose of the Study:
- To compare the clinical outcomes and structural healing of double-row versus single-row rotator cuff repair techniques.
- To evaluate if biomechanical advantages of double-row repair translate to improved functional outcomes.
Main Methods:
- Review of biomechanical and clinical studies comparing single-row and double-row rotator cuff repair.
- Analysis of data regarding load to failure, contact area, gap formation, structural healing, and functional outcomes.
Main Results:
- Biomechanical studies indicate superior mechanical properties for double-row repair.
- Clinical studies have not yet demonstrated significant functional outcome improvements or enhanced structural healing compared to single-row repair.
Conclusions:
- Despite biomechanical benefits, double-row rotator cuff repair has not shown definitive clinical superiority.
- Further high-level studies are required to ascertain the true efficacy and cost-effectiveness of double-row techniques.
