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

Background The purpose of this study was to perform a systematic review and meta-analysis of all available level I randomized controlled trials comparing single-row with double-row repair to statistically compare clinical outcomes and imaging-diagnosed re-tear rates. Methods A literature search was...

Full description

Saved in:
Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2014-04, Vol.23 (4), p.586-597
Main Authors: Millett, Peter J., MD, MSc, Warth, Ryan J., MD, Dornan, Grant J., MSc, Lee, Jared T., MD, Spiegl, Ulrich J., MD
Format: Article
Language:English
Subjects:
Arthroscopy - methods
double row
Female
Humans
Male
meta-analysis
Middle Aged
Orthopedics
Randomized Controlled Trials as Topic
Recurrence
Rotator Cuff - surgery
Rotator Cuff Injuries
rotator cuff repair
Single row
Suture Techniques
systematic review
Tendon Injuries - surgery
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background The purpose of this study was to perform a systematic review and meta-analysis of all available level I randomized controlled trials comparing single-row with double-row repair to statistically compare clinical outcomes and imaging-diagnosed re-tear rates. Methods A literature search was undertaken to identify all level I randomized controlled trials comparing structural or clinical outcomes after single-row versus double-row rotator cuff repair. Clinical outcomes measures included in the meta-analysis were the American Shoulder and Elbow Surgeons, University of California–Los Angeles, and Constant scores; structural outcomes included imaging-confirmed re-tears. Meta-analyses compared raw mean differences in outcomes measures and relative risk ratios for imaging-diagnosed re-tears after single-row or double-row repairs by a random-effects model. Results The literature search identified a total of 7 studies that were included in the meta-analysis. 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 (relative risk, 1.76 [95% confidence interval, 1.25-2.48]; P = .001), with partial-thickness re-tears accounting for the majority of this difference (relative risk, 1.99 [95% confidence interval, 1.40-3.82]; P = .039). Conclusion Single-row repairs resulted in significantly higher re-tear rates compared with double-row repairs, especially with regard to partial-thickness re-tears. However, there were no detectable differences in improvement in outcomes scores between single-row and double-row repairs.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2013.10.006