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A Novel Arthroscopic Medial Knot-Tying Suture-Bridge Repair with Rip-Stop Technique for Rotator Cuff Tears
Published on: January 13, 2026
Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55
Michael E Hantes1, Yohei Ono2, Vasilios A Raoulis1
1Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Larissa, Greece.
Insights
For young patients undergoing arthroscopic rotator cuff repair, the double-row (suture bridge) technique shows improved tendon healing compared to single-row fixation. This enhanced healing correlates with better clinical outcomes in midterm follow-up.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Achieving long-lasting structural and functional integrity after arthroscopic rotator cuff repair is crucial for young patients.
- A fixation technique promoting superior tendon healing is essential for long-term clinical success in younger populations.
Purpose of the Study:
- To compare midterm radiological and clinical outcomes of single-row versus double-row (suture bridge) fixation for arthroscopic rotator cuff repair in patients under 55 years old.
- To determine if double-row repair leads to improved tendon healing and superior clinical results compared to single-row repair.
Main Methods:
- Prospective cohort study (Level of evidence, 2) of 66 patients (<55 years) with medium to large supraspinatus/infraspinatus tears undergoing arthroscopic repair.
- Patients were divided into single-row (n=34) and double-row (n=32) groups.
- Tendon integrity assessed by MRI (Sugaya's classification) at ≥12 months; clinical outcomes evaluated using Constant and UCLA scores at ≥2 years.
Main Results:
- Mean follow-up was 46 months.
- The double-row group demonstrated a significantly higher tendon healing rate (84%) compared to the single-row group (61%) (P < .05).
- Patients with healed tendons showed superior clinical outcomes (UCLA and Constant scores) compared to those with retears, irrespective of the technique used.
Conclusions:
- The double-row repair technique offers potentially superior tendon healing compared to the single-row technique for arthroscopic rotator cuff repair.
- Double-row repair should be considered for younger patients (<55 years) with medium to large rotator cuff tears to enhance healing and clinical outcomes.
Background:
When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success. Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and double-row (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid- to long-term clinical outcomes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya's classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years.
Results:
Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [ P < .05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [ P < .05]; Constant score, 94 and 76, respectively [ P < .05]).
Conclusion:
The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.
