Meta-analysis comparing single-row and double-row repair techniques in the arthroscopic treatment of rotator cuff tears.

BACKGROUND: Rotator cuff tears are among the most common shoulder injuries and can be a source of persistent pain, disability, and decreased range of motion and strength. Our hypothesis was to conduct a meta-analysis of recently published studies to compare the clinical results of a double-row technique with the results of a single-row technique for different tear sizes. METHODS: A search was performed in the MEDLINE, EMBASE, and Ovid databases. All randomized and quasi-randomized clinical trials that reported the outcome of single-row repair and double-row repair techniques were included in our meta-analysis. Two subgroups were set according to the tear size. The outcomes were the Constant score, American Shoulder and Elbow Surgeons (ASES) score, UCLA score, re-tear rate, range of motion, and muscle strength. RESULTS: We included 9 studies in this meta-analysis, 5 of which were randomized prospective studies. There was a statistically significant difference in favor of double-row repair for the overall ASES score, re-tear rate, and internal rotation range of motion. In subgroup 2 (tear size > 30 mm in the anteroposterior dimension), double-row techniques produced better outcomes than single-row techniques. There were no statistically significant differences in the overall Constant score, UCLA score, external rotation and forward elevation range of motion, or muscle strength. CONCLUSION: Double-row rotator cuff repair techniques have a significantly lower re-tear rate, higher ASES score, and greater range of motion of internal rotation compared with single-row repair techniques. Especially in those rotator cuff tears with a size >30 mm, the double-row technique is recommended for repair.