Single-row or Double-row Rotator Cuff Repair

Background: Rotator cuff injuries are common among individuals engaged in overhead activities and can lead to pain and functional impairment. Surgical repair of these injuries can be performed using various techniques, primarily categorized into single-row and double-row repairs. The choice between these methods is influenced by factors such as the size of the tear, tissue quality, and desired biomechanical outcomes. Single-row repairs involve attaching the tendon to the bone using a single row of anchors, whereas double-row repairs use two rows of anchors to increase tendon-to-bone contact and potentially improve healing rates. The aim of this article is to compare the effectiveness of single-row versus double-row rotator cuff repair techniques. Methods: This systematic review conducted an analysis of randomized trials and cohort studies published between ۲۰۱۰ and ۲۰۲۲ that compared single-row and double-row rotator cuff repair techniques. A total of ۱۵ studies involving over ۶۰۰ patients were reviewed, focusing on post-operative outcomes such as healing rates, functional scores (including the American Shoulder and Elbow Surgeons (ASES) score), pain levels measured by the Visual Analog Scale (VAS), and re-tear rates. Data from both short-term (less than one year) and long-term (over one year) follow-up were included to assess the durability of each repair technique. Results: Results indicated that double-row repairs generally provided better outcomes compared to single-row repairs. Specifically, the healing rate for double-row repairs was approximately ۹۰% versus ۷۵% for single-row repairs. Functional scores significantly improved in both groups; however, patients who underwent double-row repairs reported higher ASES scores at follow-up, averaging ۹۲ compared to ۸۵ in the single-row group. Pain levels also demonstrated a significant reduction in the double-row group, with VAS scores decreasing from an average of ۷ pre-operatively to ۱ post-operatively. Notably, the re-tear rate was lower in the double-row group, with only ۱۰% experiencing re-tears compared to ۲۵% in the single-row group. These findings suggest that while both techniques can be effective, double-row repairs may offer advantages in healing and functional recovery. Conclusion: Both single-row and double-row techniques are viable options for rotator cuff repair. However, double-row repairs have shown superior healing rates and functional outcomes. The enhanced tendon-to-bone contact provided by double-row techniques appears to reduce the re-tear rate and improve patient satisfaction. Surgeons should consider these factors when selecting the appropriate surgical method for rotator cuff injuries.

کلیدواژه ها:

Rotator Cuff Injury ، Single-Row Repair ، Double-Row Repair ، Surgical Techniques ، Healing Rates