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Clinical and radiologic outcome of arthroscopic rotator cuff repair: single-row versus transosseous equivalent repair.

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BACKGROUND There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders. METHODS This… Click to show full abstract

BACKGROUND There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders. METHODS This study included 415 patients who underwent arthroscopic rotator cuff type I (complete coverage of the greater tuberosity footprint) or II (incomplete coverage) repair between January 2006 and December 2012. SR repair followed the conventional protocol. For double-row TOE repairs, 4 medial sutures were inserted with 2 lateral row anchors. The patients were evaluated for cuff integrity (on magnetic resonance imaging at 6 months postoperatively) and for clinical outcome (pain on the visual analog scale and various scores assessing shoulder function; all logged preoperatively and postoperatively at 3 months, 6 months, and at the last follow-up). RESULTS SR and TOE repairs were performed in 46% and 54% of patients, respectively. Type I and type II repairs were performed in 87% and 13% of patients, respectively. The overall incidence of retear assessed on postoperative magnetic resonance imaging was 6.74%. The incidence of retear in the SR group was statistically significantly higher only in large-sized tears (28.57% vs. 4.5%; P = .028). Among the postoperative scores at the final follow-up, only the function on the visual analog scale differed significantly between the groups (P < .01), with patients treated by TOE repair showing higher scores (8.47 ± 1.70 vs. 7.91 ± 1.66). CONCLUSION In this large cohort study, SR and TOE repair provided similar clinical and radiologic outcomes. Nevertheless, TOE repair was associated with significantly improved healing rate for large-sized tears.

Keywords: row; single row; rotator cuff; repair

Journal Title: Journal of shoulder and elbow surgery
Year Published: 2018

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