title: Single versus double-row repair of the rotator cuff: does double-row repair with improved anatomical and biomechanical characteristics lead to better clinical outcome?
abstract: OBJECTIVE
  Several techniques for arthroscopic repair of rotator cuff defects have been introduced over the past years. Besides established techniques such as single-row repairs, new techniques such as double-row reconstructions have gained increasing interest. The present article therefore provides an overview of the currently available literature on both repair techniques with respect to several anatomical, biomechanical, clinical and structural endpoints.
  
  
  METHODS
  Systematic literature review of biomechanical, clinical and radiographic studies investigating or comparing single- and double-row techniques. These results were evaluated and compared to provide an overview on benefits and drawbacks of the respective repair type.
  
  
  RESULTS
  Reconstructions of the tendon-to-bone unit for full-thickness tears in either single- or double-row technique differ with respect to several endpoints. Double-row repair techniques provide more anatomical reconstructions of the footprint and superior initial biomechanical characteristics when compared to single-row repair. With regard to clinical results, no significant differences were found while radiological data suggest a better structural tendon integrity following double-row fixation.
  
  
  CONCLUSIONS
  Presently published clinical studies cannot emphasize a clearly superior technique at this time. Available biomechanical studies are in favour of double-row repair. Radiographic studies suggest a beneficial effect of double-row reconstruction on structural integrity of the reattached tendon or reduced recurrent defect rates, respectively.
authors.affiliation: Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Pauly
authors.forename: Christian
authors.initials: C
authors.lastname: Gerhardt
authors.forename: Jianhai
authors.initials: J
authors.lastname: Chen
authors.forename: Markus
authors.initials: M
authors.lastname: Scheibel
mesh_terms: D001182:Arthroscopy; D001696:Biomechanical Phenomena; D006801:Humans; D017006:Rotator Cuff / Q000033:anatomy & histology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques; D013718:Tensile Strength