Saturday, January 11, 2014

Retear rates after single and double row repairs, does it matter?

Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials

The authors identified 7 level I randomized controlled trials comparing structural or clinical outcomes after single-row versus double-row rotator cuff repair.

There were no significant differences in preoperative to postoperative change in American Shoulder and Elbow Surgeons, University of California–Los Angeles, or Constant scores between the single-row and double-row groups (P = .440, .116, and .156, respectively).

The overall re-tear rate was 25.9% (68/263) in the single-row group and 14.2% (37/261) in the double-row group. There was a statistically significant increased risk of sustaining an imaging-proven re-tear of any type in the single-row group with partial-thickness re-tears accounting for the majority of this difference.

Unfortunately, the authors did not compare the clinical outcomes for the (1) full thickness retears, (2) the partial thickness retears, and (3) the intact repairs, but we can guess that - because the retear rate was greater for the single row repairs, but the outcomes were not different - repair integrity did not affect the outcome (again).

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