This Article Full Text Full Text (PDF) [Supplementary Material] Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Smith, C. D. Articles by Wallace, A. L. Search for Related Content PubMed PubMed Citation Articles by Smith, C. D. Articles by Wallace, A. L. Social Bookmarking                   What's this?

A Biomechanical Comparison of Single and Double-Row Fixation in Arthroscopic Rotator Cuff Repair

¹ The Shoulder Unit, Hospital of St. John and St. Elizabeth, 60 Grove End Road, London NWB 9NH, United Kingdom
² Department of Bioengineering, Imperial College London, Mechanical Engineering Building, Exhibition Road, London SW7 2AZ, United Kingdom. E-mail address for A.M.J. Bull: a.bull{at}imperial.ac.uk
³ Cape Shoulder Institute, P.O. Box 15741, Panorama 7506, South Africa
⁴ Departments of Musculoskeletal Surgery and Mechanical Engineering, Imperial College London, London SW7 2AZ, United Kingdom

Investigation performed at Imperial College, London, United Kingdom

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Methods: A standardized tear of the supraspinatus tendon was created in sixteen fresh cadaveric shoulders. Arthroscopic rotator cuff repairs were performed with use of either a double-row technique (eight specimens) or a single-row technique (eight specimens) with nonabsorbable sutures that were double-loaded on a titanium suture anchor. The repairs were loaded statically for one hour, and the gap formation was measured. Cyclic loading to failure was then performed.

Results: Gap formation during static loading was significantly greater in the single-row group than in the double-row group (mean and standard deviation, 5.0 ± 1.2 mm compared with 3.8 ± 1.4 mm; p < 0.05). Under cyclic loading, the double-row repairs failed at a mean of 320 ± 96.9 N whereas the single-row repairs failed at a mean of 224 ± 147.9 N (p = 0.058). Three single-row repairs and three double-row repairs failed as a result of suture cut-through. Four single-row repairs and one double-row repair failed as a result of anchor or suture failure. The remaining five repairs did not fail, and a midsubstance tear of the tendon occurred.

Conclusions: Although more technically demanding, the double-row technique demonstrates superior resistance to gap formation under static loading as compared with the single-row technique.

Clinical Relevance: A double-row reconstruction of the supraspinatus tendon insertion may provide a more reliable construct than a single-row repair and could be used as an alternative to open reconstruction for the treatment of isolated tears.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. J. Bisson and L. M. Manohar A Biomechanical Comparison of Transosseous-Suture Anchor and Suture Bridge Rotator Cuff Repairs in Cadavers Am. J. Sports Med., October 1, 2009; 37(10): 1991 - 1995. [Abstract] [Full Text] [PDF]

				R. T. Burks, J. Crim, N. Brown, B. Fink, and P. E. Greis A Prospective Randomized Clinical Trial Comparing Arthroscopic Single- and Double-Row Rotator Cuff Repair: Magnetic Resonance Imaging and Early Clinical Evaluation Am. J. Sports Med., April 1, 2009; 37(4): 674 - 682. [Abstract] [Full Text] [PDF]

				C. Howe, P. Huber, F. M. Wolf, and F. Matsen III Differential Suture Loading in an Experimental Rotator Cuff Repair Am. J. Sports Med., February 1, 2009; 37(2): 324 - 329. [Abstract] [Full Text] [PDF]

				B. G. Domb, R. E. Glousman, A. Brooks, M. Hansen, T. Q. Lee, and N. S. ElAttrache High-Tension Double-Row Footprint Repair Compared with Reduced-Tension Single-Row Repair for Massive Rotator Cuff Tears J. Bone Joint Surg. Am., November 1, 2008; 90(Supplement_4): 35 - 39. [Full Text] [PDF]

				J. B. Frank, N. S. ElAttrache, J. S. Dines, A. Blackburn, J. Crues, and J. E. Tibone Repair Site Integrity After Arthroscopic Transosseous-Equivalent Suture-Bridge Rotator Cuff Repair Am. J. Sports Med., August 1, 2008; 36(8): 1496 - 1503. [Abstract] [Full Text] [PDF]

				B. T. Busfield, R. E. Glousman, M. H. McGarry, J. E. Tibone, and T. Q. Lee A Biomechanical Comparison of 2 Technical Variations of Double-Row Rotator Cuff Fixation: The Importance of Medial Row Knots Am. J. Sports Med., May 1, 2008; 36(5): 901 - 906. [Abstract] [Full Text] [PDF]

				K. A. Turman and M. D. Miller What's New in Sports Medicine J. Bone Joint Surg. Am., January 1, 2008; 90(1): 211 - 222. [Full Text] [PDF]

				P. E. Huijsmans, M. P. Pritchard, B. M. Berghs, K. S. van Rooyen, A. L. Wallace, and J. F. de Beer Arthroscopic Rotator Cuff Repair with Double-Row Fixation J. Bone Joint Surg. Am., June 1, 2007; 89(6): 1248 - 1257. [Abstract] [Full Text] [PDF]

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2006 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.