Single-row suture anchor repair of the rotator cuff is biomechanically equivalent to double-row repair in a bovine model.
OBJECTIVE
The purpose of this study was to determine biomechanical differences in cyclic elongation and ultimate strength between double-row rotator cuff repair and single-row repair for partial rotator cuff repairs.


METHODS
We randomly assigned 18 immature bovine specimens (aged 12 to 16 weeks) to 3 repair groups (6 per group). A 1 x 2-cm defect was created at the infraspinatus tendon insertion site. Two suture anchors were implanted 1 cm apart at the anatomic insertion area for the lateral row. Two suture anchors were implanted 1 cm medial to the lateral row and 1 cm apart from each other for the medial row. Repair groups were constructed as follows: single-row repair with double-loaded suture anchors (group 1), double-row repair with single-loaded medial row and double-loaded lateral row (group 2), and double-row repair with single-loaded medial row and single-loaded lateral row (group 3). Specimens were cyclically loaded from 10 N to 90 N for 500 cycles and then loaded at 0.5 mm/s to failure. Data for cyclic elongation, with loads at 3 mm, 5 mm, and 10 mm, were analyzed via a 1-way analysis of variance (P < .05).


RESULTS
There were no significant differences for peak elongation after cyclic loading between groups. There were no significant differences between repair groups for loads at 3 mm, 5 mm, and 10 mm of elongation. Constructs typically failed by knot slippage (83%), with a single sample having tendon-suture failure (17%).


CONCLUSIONS
Double-row repair did not show a biomechanical advantage compared with single-row repair. With this result in mind, the theoretic advantage of a potentially larger footprint must be balanced against the added surgical time, complexity, and cost of double-row repair.


CONCLUSIONS
Arthroscopic surgeons should choose the best form of fixation for a given patient, without undue emphasis on single-row repair versus double-row repair. The clinical and biologic impact of footprint restoration was not addressed in this study.
Mahar
Andrew
A
Department of Orthopaedic Surgery, University of California, San Diego, California, USA. amahar@chsd.org
Tamborlane
Jeffrey
J
Oka
Richard
R
Esch
James
J
Pedowitz
Robert A
RA
D000818:Animals; D001696:Biomechanical Phenomena; D002417:Cattle; D004195:Disease Models, Animal; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D053441:Suture Anchors; D013536:Suture Techniques / Q000295:instrumentation*; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*