Five Year Follow up of Retrospective Cohort Comparing Structural and Functional Outcome of Arthroscopic Single-row versus Double-row Suture Bridge Repair of Large Posterosuperior Rotator Cuff Tear in Patients Less than or Equal to 70 Years

Document Type : RESEARCH PAPER


1 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India

2 Shoulder unit, Lairesse Kliniek, Valeriusplein, BG Amsterdam, The Netherlands


Background: High re-tear rates after repairing large-sized posterosuperior rotator cuff tears remain a significant
concern which may affect the clinical outcome. The most optimal type of repair (single versus double-row suture
bridge) suited for large size tear remains debatable.
Methods: In a retrospective cohort study with a minimum of five years follow up, the structural and functional outcome of
103 patients with large size cuff tear repaired with single row (SR) or double row suture bridge (DRSB) were evaluated.
The structural outcome was assessed with ultrasonography whereas functional outcome was evaluated with Constant
Murley (CM) and American shoulder elbow score (ASES).
Results: There were 55 patients in the SR group and 48 patients in the DRSB group with a mean follow-up of 74.2
months (range, 60-96 months). While comparing the structural integrity in two groups, we found significantly lower retear
rates in the DRSB group as compared to the SR group (10.4% vs. 32.7%; P=0.006). Also, there were more focal
defects in the SR group (25.4%) than the DRSB group (8.3%). Overall, there was no significant difference in CM and
ASES scores when the SR group was compared to DRSB. However, subgroup analysis between those with intact and
retorn tendon revealed significant difference (P=0.0001) in the clinical scores.
Conclusion: At a minimum of five years follow-up, the DRSB repair of large posterosuperior cuff tear resulted in
superior structural healing over SR repair. Nevertheless, overall there was no significant functional difference between
both the techniques. However, the functional outcome of the healed tendon subgroup was superior to retear tendon
Level of evidence: III


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