Comparative analysis of single-row vs. double-row technique for rotator cuff repair: a systematic review and...

Rotator cuff injuries are a common occurrence among general population. Surgical repair may be necessary when there are tendon and muscle injuries within the rotator cuff. This study aims to compare the outcomes of rotator cuff repair using the single-row technique vs. the double-row technique.

A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria for systematic reviews and meta-analyses, along with Cochrane recommendations. The PubMed database was searched using the following medical subject headings terms: "rotator cuff tear," "single row," and "double row," without any time restrictions. Only clinical trials were included in the analysis.

A total of 269 articles were identified, and after reviewing the full text, 14 articles were assessed for eligibility. Ultimately, 9 articles were included in the analysis, comprising a total of 662 patients with partial or full-thickness rotator cuff tears. The average follow-up period after surgery was 22 months. Most of the included studies were of good quality, although some had an unclear risk of detection bias, attrition bias, and reporting bias. The overall healing rate for the single-row repair technique was 79%, while it was 89% for the double-row repair technique (P < .001). There were no significant differences in functional outcomes between the 2 techniques when assessed using the American Shoulder and Elbow Surgeons scale (+0.83, 95% confidence interval (CI) -0.84 to 2.51, P = .799) or the Constant-Murley score (+0.30, 95% CI -0.95 to 1.56, P = .899). However, patients who underwent double-row repair had significantly higher University of California, Los Angeles scores (+0.86, 95% CI 0.37-1.34, P < .001).

Double-row repair technique is associated with a higher healing rate compared to single-row repair. However, functionally, the differences detected are not clinically relevant. Future studies should focus on long-term follow-up and functional outcomes to provide further insights into the optimal surgical technique for rotator cuff repair.