Double-Row Repair Lowers the Retear Risk After Accelerated Rehabilitation. (April 2016)

• Record Type: Journal Article
• Authors: Franceschi, Francesco; Papalia, Rocco; Franceschetti, Edoardo; Palumbo, Alessio; Del Buono, Angelo; Paciotti, Michele; Maffulli, Nicola; Denaro, Vincenzo
• Is Part Of: American journal of sports medicine. Volume 44:Number 4(2016:Apr.)
• Page Start: 948
• Page End: 956
• Publication Date: 2016-04
• Subjects: rotator cuff repair -- accelerated rehabilitation -- double row -- single row -- shoulder stiffness; Sports medicine -- Periodicals; Sports injuries -- Periodicals; Orthopedic surgery -- Periodicals; 617.102705
• DOI: 10.1177/0363546515623031
• Languages: English
• ISSNs: 0363-5465

Abstract

Background: Recently, an accelerated rehabilitation protocol after rotator cuff (RC) repair has been proposed for patients at risk of postoperative stiffness. Purpose: To investigate, in patients undergoing early accelerated mobilization, whether double-row (DR) repair provides better clinical outcomes and a lower retear rate compared with single-row (SR) configurations. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 58 patients were randomized to undergo either SR or DR repair. After 2 years of follow-up, 12 men and 13 women (mean age, 61.8 years; range, 52-67 years) in the SR group and 15 men and 10 women (mean age, 58.9 years; range, 51-69 years) in the DR group were evaluated. To assess the retear rate, magnetic resonance imaging of the shoulder was performed at 2-year follow-up. The clinical evaluation was based on the modified University of California, Los Angeles (UCLA) shoulder score and range of motion (ROM) measurements. Results: Magnetic resonance arthrography showed a significantly lower full-thickness retear rate for the DR group than for the SR group (8% vs 24%, respectively; P < .05). Conversely, at both 6-month and 2-year follow-up, there was no statistically significant difference in terms of the rate of stiffness in the SR and DR groups (8% vs 12% and 0% vs 0%, respectively; P > .05). No clinical differences were recorded regarding the UCLA score (SR group: mean, 32.6 [range, 30-35]; DR group: mean, 33.3 [range, 29-35]; P = .61) and ROM. Conclusion: In selected patients at a high risk of shoulder stiffness and therefore necessitating accelerated postoperative rehabilitation, DR repair of the RC could lower retear rates.