Simple Double-Row Rotator Cuff Repair Technique for Large and Massive Cuff Tears

Rotator cuff repairs seek to achieve adequate tendon fixation and to secure the fixation during the process of biological healing. Currently, arthroscopic rotator cuff repair has become the gold standard. One of the earliest defined techniques is single-row repair but the inadequacy of single-row repair to precisely restore the anatomical footprint as well as the significant rates of retear especially in large tears have led surgeons to seek other techniques. Double-row repair techniques, which have been developed in response to these concerns, have various modifications like the number and placement of anchors and suture configurations. When the literature is reviewed, it is possible to say that double-row repairs demonstrate superior biomechanical properties. In regard to retear rates, both double row and transosseous equivalent (TOE) techniques have also yielded more favorable outcomes compared to single-row repair. But the clinical results are conflicting and more studies have to be conducted. However, it is more probable that superior structural integrity will yield better structural and functional results in the long run. TOE repair technique is regarded as promising in terms of better biomechanics and healing since it provides better footprint contact. Knotless TOE structures are believed to reduce impingement on the medial side of tendons and thus aid in tendon nutrition; however, there are not enough studies about its effectiveness. It is important to optimize the costs without endangering the treatment of the patients. We believe that the arthroscopic TOE repair technique will yield superior results in regard to both repair integrity and functionality, especially with tears larger than 3 cm. Although defining the pattern of the tear is one of the most important guiding steps when selecting the repair technique, the surgeon should not forget to evaluate every patient individually for tendon healing capacity and functional expectations.

Download Full-text

The Arthroscopic “Montgolfier Double-Row Knotless” Rotator Cuff Repair Technique

Arthroscopy Techniques ◽

10.1016/j.eats.2019.02.014 ◽

2019 ◽

Vol 8 (7) ◽

pp. e669-e674

Author(s):

Gregory Gasbarro ◽

Lionel Neyton

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Double Row ◽

Repair Technique ◽

Cuff Repair

Download Full-text

Arthroscopic Single-Row Versus Double-Row Suture Anchor Rotator Cuff Repair

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/s1551-7977(08)70223-1 ◽

2007 ◽

Vol 2007 ◽

pp. 30-31 ◽

Cited By ~ 1

Author(s):

R.J. Goitz

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Suture Anchor ◽

Double Row ◽

Single Row ◽

Cuff Repair

Download Full-text

Clinical & Radiological Assessment of Rotator Cuff Healing After Single Row Vs. Double Row Rotator Cuff Repair

Case Medical Research ◽

10.31525/ct1-nct03885856 ◽

2019 ◽

Author(s):

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Radiological Assessment ◽

Double Row ◽

Single Row ◽

Cuff Repair

Download Full-text

Minimum 10-Year Outcomes of Primary Arthroscopic Transosseous-Equivalent Double-Row Rotator Cuff Repair

The American Journal of Sports Medicine ◽

10.1177/03635465211015419 ◽

2021 ◽

pp. 036354652110154

Author(s):

Adam M. Johannsen ◽

Justin W. Arner ◽

Bryant P. Elrick ◽

Philip-C. Nolte ◽

Dylan R. Rakowski ◽

...

Keyword(s):

Rotator Cuff ◽

Revision Surgery ◽

Rotator Cuff Repair ◽

Patient Reported Outcomes ◽

Long Term Results ◽

Double Row ◽

Kaplan Meier ◽

Patient Reported ◽

Cuff Repair

Background: Modern rotator cuff repair techniques demonstrate favorable early and midterm outcomes, but long-term results have yet to be reported. Purpose: To determine 10-year outcomes and survivorship after arthroscopic double-row transosseous-equivalent (TOE) rotator cuff repair. Study Design: Case series; Level of evidence 4. Methods: The primary TOE rotator cuff repair procedure was performed using either a knotted suture bridge or knotless tape bridge technique on a series of patients with 1 to 3 tendon full-thickness rotator cuff tears involving the supraspinatus. Only patients who were 10 years postsurgery were included. Patient-reported outcomes were collected pre- and postoperatively, including American Shoulder and Elbow Surgeons (ASES), 12-Item Short Form Health Survey (SF-12), Single Assessment Numeric Evaluation (SANE), shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and satisfaction. Kaplan-Meier survivorship analysis was performed. Failure was defined as progression to revision surgery. Results: A total of 91 shoulders (56 men, 31 women) were included between October 2005 and December 2009. Mean follow-up was 11.5 years (range, 10.0-14.1 years). Of 91 shoulders, 5 (5.5%) failed and required revision surgery. Patient-reported outcomes for patients who survived were known for 80% (69/86). Outcomes scores at final follow-up were as follows: ASES, 93.1 ± 10.8; SANE, 87.5 ± 14.2; QuickDASH, 11.1 ± 13.5; and SF-12 physical component summary (PCS), 49.2 ± 10.1. There were statistically significant declines in ASES, SANE, and SF-12 PCS from the 5-year to 10-year follow-up, but none of these changes met the minimally clinically important difference threshold. Median satisfaction at final follow-up was 10 (range, 3-10). From this cohort, Kaplan-Meier survivorship demonstrated a 94.4% survival rate at a minimum of 10 years. Conclusion: Arthroscopic TOE rotator cuff repair demonstrates high patient satisfaction and low revision rates at a mean follow-up of 11.5 years. This information may be directly utilized in surgical decision making and preoperative patient counseling regarding the longevity of modern double-row rotator cuff repair.

Download Full-text