title: Double-Row Repair Lowers the Retear Risk After Accelerated Rehabilitation.
abstract: BACKGROUND
  Recently, an accelerated rehabilitation protocol after rotator cuff (RC) repair has been proposed for patients at risk of postoperative stiffness.
  
  
  OBJECTIVE
  To investigate, in patients undergoing early accelerated mobilization, whether double-row (DR) repair provides better clinical outcomes and a lower retear rate compared with single-row (SR) configurations.
  
  
  METHODS
  Randomized controlled trial; Level of evidence, 1.
  
  
  METHODS
  A total of 58 patients were randomized to undergo either SR or DR repair. After 2 years of follow-up, 12 men and 13 women (mean age, 61.8 years; range, 52-67 years) in the SR group and 15 men and 10 women (mean age, 58.9 years; range, 51-69 years) in the DR group were evaluated. To assess the retear rate, magnetic resonance imaging of the shoulder was performed at 2-year follow-up. The clinical evaluation was based on the modified University of California, Los Angeles (UCLA) shoulder score and range of motion (ROM) measurements.
  
  
  RESULTS
  Magnetic resonance arthrography showed a significantly lower full-thickness retear rate for the DR group than for the SR group (8% vs 24%, respectively; P < .05). Conversely, at both 6-month and 2-year follow-up, there was no statistically significant difference in terms of the rate of stiffness in the SR and DR groups (8% vs 12% and 0% vs 0%, respectively; P > .05). No clinical differences were recorded regarding the UCLA score (SR group: mean, 32.6 [range, 30-35]; DR group: mean, 33.3 [range, 29-35]; P = .61) and ROM.
  
  
  CONCLUSIONS
  In selected patients at a high risk of shoulder stiffness and therefore necessitating accelerated postoperative rehabilitation, DR repair of the RC could lower retear rates.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Franceschetti
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Palumbo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Del Buono
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Paciotti
authors.affiliation: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, UK n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000368:Aged; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D011446:Prospective Studies; D012008:Recurrence; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques
keywords: accelerated rehabilitation; double row; rotator cuff repair; shoulder stiffness; single row