Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up.
BACKGROUND
Although arthroscopic repairs of the rotator cuff are becoming increasingly popular, security of fixation remains a concern. Two-row repairs have been described, but clinical outcome reports have primarily involved open techniques.


OBJECTIVE
An arthroscopic repair technique that uses 2 rows of fixation produces satisfactory outcome and structural integrity by ultrasonography.


METHODS
Case series; Level of evidence, 4.


METHODS
Forty-eight patients (52 shoulders) with a full-thickness, but fully reducible, rotator cuff tear who met the inclusion criteria were treated with an arthroscopic rotator cuff repair using 2 rows of suture anchors. The mean tear size was 2.47 cm (range, 1-4 cm). Patients were evaluated by subjective functional assessment (L'Insalata Shoulder Rating Questionnaire), clinical examination, including measured strength testing, and ultrasonography.


RESULTS
At a mean follow-up of 30 months (minimum of 2 years), functional scores improved from a mean of 42 preoperatively to 93 postoperatively (P < .001). Active range of motion was increased in all measured planes (P < .001). Strength was also increased in elevation (P < .001), external rotation (P < .001), and internal rotation (P = .033). Nine of the 52 shoulders (17%) had evidence of retear or persistent defect on postoperative ultrasonography. There were no differences detected in functional scores between those with an intact repair and those with a defect, but those with an intact repair were stronger in elevation (P = .006) and external rotation (P = .001).


CONCLUSIONS
An arthroscopic 2-row rotator cuff repair produces excellent functional outcome and repair integrity comparable with previously reported open repairs. Presence of a defect after repair did not appear to affect patient-reported function and return to preinjury activity but did affect measured strength.
Anderson
Kyle
K
Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA. Kanderson_md@hotmail.com
Boothby
Michael
M
Aschenbrener
Daniel
D
van Holsbeeck
Marnix
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D000070599:Shoulder Injuries; D013536:Suture Techniques; D016896:Treatment Outcome