Double-row repair superior to single-row repair in radiographic healing for rotator cuff repair
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SAN DIEGO — Single-row repair with an arthroscopic Mason-Allen configuration provides comparable clinical results to those obtained with the double-row repair type, but radiographic healing is significantly improved in double-row repairs, according to a Wisconsin orthopedic surgeon.
The study, which aimed to compare the double-row fixation to the single-row fixation of simple over horizontal configuration, included an assessment of 132 arthroscopic rotator cuff repair (ARCR) patients — 78 who received single-row repair and 54 with double-row repair.
“In performing our outcome analysis, we had three clinical questions,” William T. Pennington, MD, said Thursday at the 28th Annual Meeting of the Arthroscopy Association of North America. “Is double-row repair superior to single-row repair in clinical situations? Do double-row repairs have increased radiographic healing rates? And does radiographic healing rate correlate with clinical outcome?”
All of the patients were evaluated using Visual Analog Scale (VAS), University of California, Los Angeles (UCLA) and American Shoulder and Elbow Surgeons (ASES) scores, as well as planes of active motion and dynometric strength. The researchers obtained scores and measurements preoperatively and at 3, 6, 12 and 24 months postoperatively, he said.
Pennington observed no statistically significant difference in preoperative values in functional outcomes between groups in all parameters. Still, postoperative VAS, UCLA, ASES scores and strength measurements were marginally better in the single-row group. ROM measurements showed slightly better in the double-row repair group.
Subjectively, patients in the single-row repair group showed a satisfaction rate of 91%, while patients in the double-row repair group showed a satisfaction rate of 92%. When placed under an MRI, the double-row group showed significantly improved healing rates when compared to single-row repair.
Moderator Larry D. Field, MD, commended the study, but expressed a few concerns.
“This study, like others recently published, for the most part shows comparable outcomes regardless of suture anchor orientation,” he said. “Unfortunately, like other studies as well, intraoperative determinations were made by the authors regarding whether a single-row or double-row construct was utilized. Consequently, it limits the conclusions that can be drawn relating to whether a single-row or double-row repair serves their patients best.”
For more information:
- William T. Pennington, MD, is a clinical instructor of orthopedic surgery at the Medical College of Wisconsin. He can be reached at The Orthopedic Institute of Wisconsin, 3111 W. Rawson Avenue, Suite 200, Franklin, WI 53132; (414) 325-4320; e-mail: wpennington@theorthoinstitute.com.
Reference:
- Pennington, WT. Functional outcomes and radiographic appearance of single versus double-row rotator cuff repair. Presented at the 28th Annual Meeting of the Arthroscopy Association of North America. April 30-May 3, 2009.