Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis.

ABSTRACT: BACKGROUND: The single-row and double-row fixation techniques have been widely used for rotator cuff tears. However, whether the double-row technique produces superior clinical or anatomic outcomes is still considered controversial. This study aims to use meta-analysis to compare the clinical and anatomical outcomes between the two techniques. METHODS: The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before November 1, 2012. Studies clearly reporting a comparison of the single-row and double-row techniques were selected. The Constant, ASES, and UCLA scale systems and the rotator cuff integrity rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model. RESULTS: Eight studies were included in this meta-analysis. The weighted mean differences of the ASES (-0.84; P?=?0.04; I(2)?=?0%) and UCLA (-0.75; P?=?0.007; I(2)?=?0%) scales were significantly low in the single-row group for full-thickness rotator cuff tears. For tear sizes smaller than 3 cm, no significant difference was found between the groups no matter in Constant (P?=?0.95; I(2)?=?0%), ASES (P?=?0.77; I(2)?=?0%), or UCLA (P?=?0.24; I(2)?=?13%) scales. For tear sizes larger than 3 cm, the ASES (-1.95; P?=?0.001; I(2)?=?49%) and UCLA (-1.17; P?=?0.006; I(2)?=?0%) scales were markedly lower in the single-row group. The integrity of the rotator cuff (0.81; P?=?0.0004; I(2)?=?10%) was greater and the partial thickness retear rate (1.93; P?=?0.007; I(2)?=?10%) was less in the double-row group. Full-thickness retears showed no difference between the groups (P?=?0.15; I(2)?=?0%). CONCLUSION: The meta-analysis suggests that the double-row fixation technique increases post-operative rotator cuff integrity and improves the clinical outcomes, especially for full-thickness rotator cuff tears larger than 3 cm. For tear sizes smaller than 3 cm, there was no difference in the clinical outcomes between the two techniques. LEVEL OF EVIDENCE: Level I.

SUBMITTER: Zhang Q 

PROVIDER: S-EPMC3708899 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature