SINGLE-ROW VS DOUBLE ROW REPAIR - RETEARS

Seven high and five moderate quality randomized controlled trials (RCTs) utilizing magnetic resonance imaging (MRI) reported the re-tear rates after single row versus double row repair in patients with full-thickness rotator cuff tears (Heuberer, 2020; Franceshi, 2016; Franceschi, 2007; Grasso, 2009; Koh, 2011; Lapner, 2012; Lapner, 2021a; Barber 2016; Burks, 2009; Imam 2020; Carbonel, 2012; Chen, 2023; Adil, 2023; Bae, 2024; Bushnell, 2021; Chen, 2019; Dogar, 2021; Hantes, 2018; Ma 2012; Moon, 2018; Pandey, 2021; Plachel, 2020; Pulatkan, 2020; Rhee, 2023; Tashjian, 2018; Xie, 2023; Yoon, 2019).

A meta-analysis of the available pooled data indicated that double row repairs can result in lower partial retear rates than single row repairs (RR = 0.50 (0.28, 0.89). When re-tears are defined as full-thickness, however, while the studies trended in favor of double row repairs, the pooled results did not reach significance (RR = 0.76 (0.36, 1.60)).

Risks and Harms of Implementing this Recommendation
There is no harm to patients by implementing this recommendation. However, partial and full-thickness re-tear rates may be higher after single vertical mattress repair compared to double row in patients with full-thickness rotator cuff tears. The clinical significance is unknown.

Future Research
Future research should be performed to evaluate failure rates based on imaging and reoperation rates when comparing single row to double row repair for full-thickness rotator cuff tears. Research also needs to be done to better identify the clinical significance of a partial-thickness re-tear after arthroscopic rotator cuff repair.