A multicenter randomized controlled trial comparing single-row with double-row fixation in arthroscopic rotator cuff...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Optimal arthroscopic rotator cuff repair technique remains debated.
• This study addresses the controversy by comparing single-row and double-row suture methods.
• Rotator cuff injuries affect a significant patient population, necessitating effective surgical solutions.

Purpose of the Study:

• To compare functional outcomes and healing rates of single-row versus double-row arthroscopic rotator cuff repair.
• To evaluate patient-reported outcomes using the Western Ontario Rotator Cuff (WORC) index.
• To assess secondary outcomes including Constant and American Shoulder and Elbow Surgeons (ASES) scores, and arm strength.

Main Methods:

• A multicenter, randomized, double-blind controlled study involving 90 patients.
• Patients were randomized to either single-row or double-row arthroscopic rotator cuff repair.
• Outcomes were assessed using WORC, Constant, and ASES scores, strength measurements, and MRI/ultrasonography for healing rates.

Main Results:

• No significant differences in WORC, Constant, or ASES scores, or strength were observed between the two groups at any time point.
• All patients showed significant improvement in WORC scores from baseline post-surgery.
• Logistic regression indicated that smaller initial tear size and double-row fixation were associated with higher healing rates.

Conclusions:

• Single-row and double-row arthroscopic rotator cuff repair techniques yield similar functional and quality-of-life outcomes.
• Double-row fixation and smaller initial tear size are predictors of improved rotator cuff healing.
• The choice of technique may be influenced by tear size to optimize anatomical healing.