A Prospective Randomized Clinical Trial Comparing Arthroscopic Single-and Double-Row Rotator Cuff Repair

肩袖 医学 袖口 肩袖损伤 运动范围 外科 磁共振成像 肌腱 外旋 随机对照试验 生物力学 关节镜检查 放射科 解剖
作者
Robert T. Burks,Julia R. Crim,Nicholas A. T. Brown,B Fink,Patrick E. Greis
出处
期刊:American Journal of Sports Medicine [SAGE Publishing]
卷期号:37 (4): 674-682 被引量:269
标识
DOI:10.1177/0363546508328115
摘要

Background Double-row arthroscopic rotator cuff repair has become more popular, and some studies have shown better footprint coverage and improved biomechanics of the repair. Hypothesis Double-row rotator cuff repair leads to superior cuff integrity and early clinical results compared with single-row repair. Study Design Randomized controlled trial; Level of evidence, 1. Methods Forty patients were randomized to either single-row or double-row rotator cuff repair at the time of surgical intervention. Patients were followed with clinical measures (UCLA, Constant, WORC, SANE, ASES, as well as range of motion, internal rotation strength, and external rotation strength). Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively, 6 weeks, 3 months, and 1 year after repair. Results Mean anteroposterior tear size by MRI was 1.8 cm. A mean of 2.25 anchors for single row (SR) and 3.2 for double row (DR) were used. There were 2 retears at 1 year in each group. There were 2 additional cases that had severe thinning in the DR repair group at 1 year. The MRI measurements of footprint coverage, tendon thickness, and tendon signal showed no significant differences between the 2 repair groups. At 1 year, there were no differences in any of the postoperative measures of motion or strength. At 1 year, mean WORC (SR, 84.8; DR, 87.9), Constant (SR, 77.8; DR, 74.4), ASES (SR, 85.9; DR, 85.5), UCLA (SR, 28.6; DR, 29.5), and SANE (SR, 90.9; DR, 89.9) scores showed no significant differences between groups. Conclusions No clinical or MRI differences were seen between patients repaired with a SR or DR technique.
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