Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Sports Medicine

Background:

• Rotator cuff tears are common injuries treated with single-row or double-row fixation techniques.
• The clinical superiority of double-row fixation over single-row remains a subject of debate.
• This meta-analysis evaluates comparative outcomes of these two surgical methods.

Purpose of the Study:

• To compare the clinical and anatomical outcomes of single-row versus double-row rotator cuff repair techniques.
• To determine if double-row fixation offers superior results for rotator cuff tears.
• To analyze outcomes based on tear size.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library databases up to November 2012.
• Inclusion of studies directly comparing single-row and double-row rotator cuff repair.
• Meta-analysis of Constant, ASES, and UCLA scores, and rotator cuff integrity rates using fixed- or random-effects models.

Main Results:

• Double-row repair showed improved rotator cuff integrity and reduced partial-thickness retears.
• For full-thickness tears >3 cm, double-row fixation yielded significantly better ASES and UCLA scores.
• No significant clinical outcome differences were observed between techniques for tears <3 cm.

Conclusions:

• The double-row fixation technique is associated with enhanced post-operative rotator cuff integrity.
• Double-row repair improves clinical outcomes, particularly for large full-thickness rotator cuff tears (>3 cm).
• For smaller rotator cuff tears (<3 cm), clinical outcomes are comparable between single-row and double-row techniques.