title: Double-Row Capsulolabral Repair Increases Load to Failure and Decreases Excessive Motion.
abstract: Using a cadaver shoulder instability model and load-testing device, we compared biomechanical characteristics of double-row and single-row capsulolabral repairs. We hypothesized a greater reduction in glenohumeral motion and translation and a higher load to failure in a mattress double-row capsulolabral repair than in a single-row repair.
  
  
  
  In 6 matched pairs of cadaveric shoulders, a capsulolabral injury was created. One shoulder was repaired with a single-row technique, and the other with a double-row mattress technique. Rotational range of motion, anterior-inferior translation, and humeral head kinematics were measured. Load-to-failure testing measured stiffness, yield load, deformation at yield load, energy absorbed at yield load, load to failure, deformation at ultimate load, and energy absorbed at ultimate load.
  
  
  
  Double-row repair significantly decreased external rotation and total range of motion compared with single-row repair. Both repairs decreased anterior-inferior translation compared with the capsulolabral-injured condition, however, no differences existed between repair types. Yield load in the single-row group was 171.3 ± 110.1 N, and in the double-row group it was 216.1 ± 83.1 N (P = .02). Ultimate load to failure in the single-row group was 224.5 ± 121.0 N, and in the double-row group it was 373.9 ± 172.0 N (P = .05). Energy absorbed at ultimate load in the single-row group was 1,745.4 ± 1,462.9 N-mm, and in the double-row group it was 4,649.8 ± 1,930.8 N-mm (P = .02).
  
  
  
  In cases of capsulolabral disruption, double-row repair techniques may result in decreased shoulder rotational range of motion and improved load-to-failure characteristics.
  
  
  
  In cases of capsulolabral disruption, repair techniques with double-row mattress repair may provide more secure fixation. Double-row capsulolabral repair decreases shoulder motion and increases load to failure, yield load, and energy absorbed at yield load more than single-row repair.
authors.affiliation: Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address: lucas.s.mcdonald@gmail.com.
authors.forename: Lucas S
authors.initials: LS
authors.lastname: McDonald
authors.affiliation: Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Matthew
authors.initials: M
authors.lastname: Thompson
authors.affiliation: Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Health System and University of California, Irvine, Long Beach, California, U.S.A.
authors.forename: Michelle H
authors.initials: MH
authors.lastname: McGarry
authors.affiliation: Orthopaedic Biomechanics Laboratory, VA Long Beach Health System and University of California, Irvine, Long Beach, California, U.S.A.
authors.forename: Thay Q
authors.initials: TQ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California, U.S.A.
authors.forename: Vanna J
authors.initials: VJ
authors.lastname: Rocchi
authors.affiliation: Department of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Dines
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D008875:Middle Aged; D016059:Range of Motion, Articular; D012399:Rotation; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques; D055815:Young Adult