title: Double-row vs single-row rotator cuff repair: a review of the biomechanical evidence.
abstract: OBJECTIVE
  A review of the current literature will show a difference between the biomechanical properties of double-row and single-row rotator cuff repairs.
  
  
  BACKGROUND
  Rotator cuff tears commonly necessitate surgical repair; however, the optimal technique for repair continues to be investigated. Recently, double-row repairs have been considered an alternative to single-row repair, allowing a greater coverage area for healing and a possibly stronger repair.
  
  
  METHODS
  We reviewed the literature of all biomechanical studies comparing double-row vs single-row repair techniques. Inclusion criteria included studies using cadaveric, animal, or human models that directly compared double-row vs single-row repair techniques, written in the English language, and published in peer reviewed journals. Identified articles were reviewed to provide a comprehensive conclusion of the biomechanical strength and integrity of the repair techniques.
  
  
  RESULTS
  Fifteen studies were identified and reviewed. Nine studies showed a statistically significant advantage to a double-row repair with regards to biomechanical strength, failure, and gap formation. Three studies produced results that did not show any statistical advantage. Five studies that directly compared footprint reconstruction all demonstrated that the double-row repair was superior to a single-row repair in restoring anatomy.
  
  
  CONCLUSIONS
  The current literature reveals that the biomechanical properties of a double-row rotator cuff repair are superior to a single-row repair.
  
  
  METHODS
  Basic Science Study, SRH = Single vs. Double Row RCR.
authors.affiliation: Department of Orthopaedic Surgery, Washington University, St Louis, MO 63110, USA. wallli@wudosis.wustl.edu
authors.forename: Lindley B
authors.initials: LB
authors.lastname: Wall
authors.forename: Jay D
authors.initials: JD
authors.lastname: Keener
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
mesh_terms: D001696:Biomechanical Phenomena; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries