Arthroscopic single-row versus double-row suture anchor rotator cuff repair.
BACKGROUND
Recurrent defects after open and arthroscopic rotator cuff repair are common. Double-row repair techniques may improve initial fixation and quality of rotator cuff repair.


OBJECTIVE
To evaluate the load to failure, cyclic displacement, and anatomical footprint of 4 arthroscopic rotator cuff repair techniques.


OBJECTIVE
Double-row suture anchor repair would have superior structural properties and would create a larger footprint compared to single-row repair.


METHODS
Controlled laboratory study.


METHODS
Twenty fresh-frozen cadaveric shoulders were randomly assigned to 4 arthroscopic repair techniques. The repair was performed as either a single-row technique or 1 of 3 double-row techniques: diamond, mattress double anchor, or modified mattress double anchor. Angle of loading, anchor type, bone mineral density, anchor distribution, angle of anchor insertion, arthroscopic technique, and suture type and size were all controlled. Footprint length and width were quantified before and after repair. Displacement with cyclic loading and load to failure were determined.


RESULTS
There were no differences in load to failure and displacement with cyclic loading between the single-row repair and each double-row repair. All repair groups demonstrated load to failure greater than 250 N. A significantly greater supraspinatus footprint width was seen with double-row techniques compared to single-row repair.


CONCLUSIONS
The single-row repair technique was similar to the double-row techniques in load to failure, cyclic displacement, and gap formation. The double-row anchor repairs consistently restored a larger footprint than did the single-row method.


CONCLUSIONS
The arthroscopic techniques studied have strong structural properties that approached the reported performance of open repair techniques. Double-row techniques provide a larger footprint width; although not addressed by this study, such a factor may improve the biological quality of repair.
Mazzocca
Augustus D
AD
Department of Orthopaedic Surgery, University of Connecticut Health Center, 10 Talcott Notch Road, Farmington, CT 06034, USA. admazzocca@yahoo.com
Millett
Peter J
PJ
Guanche
Carlos A
CA
Santangelo
Stephen A
SA
Arciero
Robert A
RA
D020341:Absorbable Implants; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D002102:Cadaver; D006801:Humans; D008875:Middle Aged; D011897:Random Allocation; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013314:Stress, Mechanical; D013536:Suture Techniques