Double-row suture fixation in rotator cuff repair preserved joint function at 10 years
Click Here to Manage Email Alerts
TAMPA, Fla. — Despite similar functional outcomes at 10 years, a double-row suture technique in arthroscopic rotator cuff repair better preserved joint function compared with a single-row suture technique, presented results showed.
“Failure and non-healing of the rotator cuff is the most common complication for 20% to 60% [of patients],” Peter B. MacDonald, MD, FRCSC, said in his presentation at the American Shoulder and Elbow Surgeons (ASES) Annual Meeting. “The addition of the second-row [of sutures] was devised to improve healing rates,” he added.
MacDonald and colleagues compared 43 patients who underwent arthroscopic repair of a full-thickness rotator cuff tear with single-row suture fixation and a matched cohort of 34 patients who underwent the procedure with double-row fixation. Outcome measures included the Western Ontario Rotator Cuff index (WORC), ASES score, Constant score and revision rates, according to the abstract.
From 2-year to 10-year follow-up, mean change in WORC was 11.5 for the single-row cohort and –0.2 for the double-row cohort. Decrease in ASES score from 2 to 10 years was 9.2 for the single-row cohort and 6.2 for the double-row cohort. Constant scores also exhibited a nonsignificant decrease in both the single- and double-row cohorts (9.4 and 14.4, respectively). Two patients from the double-row cohort and one patient from the single-row cohort developed a full-thickness tear at 2 years, and one patient from each cohort required revision at 2 years.
“No significant differences were observed between the single-row repair vs. double- row repair with regard to quality or functional outcome measures,” the researchers wrote in the abstract. “However, double-row fixation led to preservation of joint function to 10 years, while single-row fixation demonstrated a clinically important functional decline in two of the three outcome tools used.”
Perspective
Back to Top
The optimal surgical technique for arthroscopic rotator cuff repair remains controversial, with single-anchor row vs. double-row techniques being highlighted. The latter were shown as biomechanically superior and improving footprint coverage. However, repair emphasizing footprint coverage may over-tension the cuff tendons and risk shoulder stiffness and medial failure of the repair. Evidence regarding the preferable technique is mixed, as both techniques demonstrated good to excellent outcomes at short- and midterm follow-up.
The study by Lapner and colleagues is one of the first to demonstrate long-term advantages for double-row over single-row techniques in preserving joint function. While the study sample is small and there are potential confounding factors that need to be accounted for, these results are encouraging and should promote larger future studies.
Collapse
Lapner P, et al. Paper 36. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Dec. 15-17, 2021; Tampa, Fla.
Read more about
Click Here to Manage Email Alerts