Single-Row versus Double-Row Arthroscopic Repair for Rotator Cuff Tears: A Systematic Review

Abstract

Introduction: The optimal surgical construct for repairing rotator cuff tears is a subject of debate. This review compares the biomechanical and clinical outcomes of single-row versus double-row suture anchor fixation techniques.

Methods: We conducted a search of MEDLINE and CENTRAL for RCTs comparing single-row to double-row repair for full-thickness rotator cuff tears. Primary outcomes were functional scores (e.g., Constant score) and imaging-based re-tear rates.

Results: The meta-analysis of 20 RCTs showed no significant difference in clinical or functional outcomes between single-row and double-row repair techniques at final follow-up. However, the double-row repair technique was associated with a statistically significant lower rate of re-tears on postoperative imaging.

Discussion: While a double-row repair provides a biomechanically stronger construct and better healing rates on imaging, this anatomical advantage does not consistently translate into superior clinical function for most patients. The clinical relevance of the lower re-tear rate is unclear.

Conclusion: Double-row rotator cuff repair results in lower imaging-based re-tear rates but does not offer superior clinical or functional outcomes compared to single-row repair.