Franceschi, Am J Sports Med 2007 - Equivalent Clinical Results of Arthroscopic Single-Row and Double-Row Suture Anchor Repair for Rotator Cuff Tears: A Randomized Controlled Trial
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Equivalent Clinical Results of Arthroscopic Single-Row and Double-Row Suture Anchor Repair for Rotator Cuff Tears: A Randomized Controlled Trial
Franceschi, Denaro, et al.·Am J Sports Med·2007·417 citations·RCT
Franceschi and colleagues compared arthroscopic single‑row with double‑row suture anchor repair of large and massive rotator cuff tears for clinical outcome and repair integrity.
Level 1 randomized trial of 60 patients, 30 per technique, with 4 per arm lost before the 2‑year review.
The authors hypothesized that clinical and imaging outcomes would not differ between the two anchor configurations.
Methods
Design
Randomized controlled trial
Level of evidence 1
Setting
Campus Biomedico University, Rome, Italy
One surgeon
Patients
60 patients with large and massive rotator cuff tears
52 seen at final follow‑up (26 per group)
60 of 197 screened were eligible
Only unretracted, mobile tears that allowed a double‑row repair, randomized at arthroscopy
Groups
Single‑row anchor repair to the lateral footprint (n = 30)
Double‑row anchor repair to the medial and lateral footprint (n = 30)
Follow-up
Mean 22.5 months (range 18 to 25)
Outcomes
UCLA shoulder score
Range of motion
Cuff integrity on MR arthrography
Operative time
Key Findings
At 2 years, UCLA scores did not differ significantly between techniques (32.9 single‑row vs 33.3 double‑row), and neither did range of motion.
Double‑row repair took significantly longer, with a mean of 65 minutes vs 42 minutes for single‑row repair (p = 0.005).
Both groups improved significantly from baseline, with UCLA scores rising from 11.5 to 32.9 after single‑row repair and from 10.1 to 33.3 after double‑row repair (p < 0.05).
The authors did no formal power analysis and set the sample size by what their unit could deliver.
There were no infections or neurological or vascular complications.
Board pearl
In large and massive tears, double‑row repair added operative time (65 vs 42 minutes) without a significant gain in 2‑year UCLA score or MR‑arthrography healing over single‑row repair.
Authors' conclusion
Single- and double-row techniques provide comparable clinical outcome at 2 years. A double-row technique produces a mechanically superior construct compared with the single-row method in restoring the anatomical footprint of the rotator cuff, but these mechanical advantages do not translate into superior clinical performance.
Franceschi and colleagues compared arthroscopic single‑row with double‑row suture anchor repair of large and massive rotator cuff tears for clinical outcome and repair integrity.
Level 1 randomized trial of 60 patients, 30 per technique, with 4 per arm lost before the 2‑year review.
The authors hypothesized that clinical and imaging outcomes would not differ between the two anchor configurations.
Methods
Design
Randomized controlled trial
Level of evidence 1
Setting
Campus Biomedico University, Rome, Italy
One surgeon
Patients
60 patients with large and massive rotator cuff tears
52 seen at final follow‑up (26 per group)
60 of 197 screened were eligible
Only unretracted, mobile tears that allowed a double‑row repair, randomized at arthroscopy
Groups
Single‑row anchor repair to the lateral footprint (n = 30)
Double‑row anchor repair to the medial and lateral footprint (n = 30)
Follow-up
Mean 22.5 months (range 18 to 25)
Outcomes
UCLA shoulder score
Range of motion
Cuff integrity on MR arthrography
Operative time
Key Findings
At 2 years, UCLA scores did not differ significantly between techniques (32.9 single‑row vs 33.3 double‑row), and neither did range of motion.
Double‑row repair took significantly longer, with a mean of 65 minutes vs 42 minutes for single‑row repair (p = 0.005).
Both groups improved significantly from baseline, with UCLA scores rising from 11.5 to 32.9 after single‑row repair and from 10.1 to 33.3 after double‑row repair (p < 0.05).
The authors did no formal power analysis and set the sample size by what their unit could deliver.
There were no infections or neurological or vascular complications.
Board pearl
In large and massive tears, double‑row repair added operative time (65 vs 42 minutes) without a significant gain in 2‑year UCLA score or MR‑arthrography healing over single‑row repair.
Authors' conclusion
Single- and double-row techniques provide comparable clinical outcome at 2 years. A double-row technique produces a mechanically superior construct compared with the single-row method in restoring the anatomical footprint of the rotator cuff, but these mechanical advantages do not translate into superior clinical performance.