This is a systematic review of overlapping meta-analyses comparing single-row versus double-row arthroscopic rotator cuff repair. Because prior meta-analyses reached conflicting conclusions, the authors use quality scoring and the Jadad algorithm to identify which evidence is most trustworthy. The goal is to determine whether double-row repair truly offers superior healing or clinical outcomes.
When you see conflicting meta-analyses on the same question, do not assume the data conflict. Grade the reviews first. This paper is a model of that discipline: after quality scoring and the Jadad algorithm, the discordance largely collapsed. The best Level I evidence favored double-row repair for tendon healing.
The clinical pearl is the disconnect between structural and clinical outcomes. Double-row heals the tendon more reliably, but patients do not report meaningfully better function. This is a recurring theme in cuff surgery and a common board trap.
DR is not free. It costs more, takes longer, and adds a medial-row failure mechanism at the musculotendinous junction that can be nearly impossible to revise. For board purposes, remember the split verdict: DR wins on healing, ties on clinical outcome, and the largest signal is in tears greater than 3 cm.
This is a systematic review of overlapping meta-analyses comparing single-row versus double-row arthroscopic rotator cuff repair. Because prior meta-analyses reached conflicting conclusions, the authors use quality scoring and the Jadad algorithm to identify which evidence is most trustworthy. The goal is to determine whether double-row repair truly offers superior healing or clinical outcomes.
When you see conflicting meta-analyses on the same question, do not assume the data conflict. Grade the reviews first. This paper is a model of that discipline: after quality scoring and the Jadad algorithm, the discordance largely collapsed. The best Level I evidence favored double-row repair for tendon healing.
The clinical pearl is the disconnect between structural and clinical outcomes. Double-row heals the tendon more reliably, but patients do not report meaningfully better function. This is a recurring theme in cuff surgery and a common board trap.
DR is not free. It costs more, takes longer, and adds a medial-row failure mechanism at the musculotendinous junction that can be nearly impossible to revise. For board purposes, remember the split verdict: DR wins on healing, ties on clinical outcome, and the largest signal is in tears greater than 3 cm.