Does the literature support double-row suture anchor fixation for arthroscopic rotator cuff repair? A systematic review comparing double-row and single-row suture anchor configuration.
OBJECTIVE
The purpose of this study was to compare the clinical outcome of single-row (SR) and double-row (DR) suture anchor fixation in arthroscopic rotator cuff repair with a systematic review of the published literature.


METHODS
We searched all published literature from January 1966 to December 2008 using Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials for the following key words: shoulder, rotator cuff, rotator cuff tear, rotator cuff repair, arthroscopic, arthroscopic-assisted, single row, double row, and transosseous equivalent. The inclusion criteria were cohort studies (Levels I to III) that compared SR and DR suture anchor configuration for the arthroscopic treatment of full-thickness rotator cuff tears. The exclusion criteria were studies that lacked a comparison group, and, therefore, case series were excluded from the analysis.


RESULTS
There were 5 studies that met the criteria and were included in the final analysis: 5 in the SR group and 5 in the DR group. Data were abstracted from the studies for patient demographics, rotator cuff tear characteristics, surgical procedure, rehabilitation, range of motion, clinical scoring systems, and imaging studies.


CONCLUSIONS
There are no clinical differences between the SR and DR suture anchor repair techniques for arthroscopic rotator cuff repairs. At present, the data in the published literature do not support the use of DR suture anchor fixation to improve clinical outcome, but there are some studies that report that DR suture anchor fixation may improve tendon healing.


METHODS
Level III, systematic review of Levels I to III studies.
Nho
Shane J
SJ
Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, and Rush Medical College of Rush University, Chicago, Illinois, USA. snho@hotmail.com
Slabaugh
Mark A
MA
Seroyer
Shane T
ST
Grumet
Robert C
RC
Wilson
Joseph B
JB
Verma
Nikhil N
NN
Romeo
Anthony A
AA
Bach
Bernard R
BR
D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D053441:Suture Anchors; D013536:Suture Techniques; D016896:Treatment Outcome