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From the Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan, Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, St Joseph Mercy-Oakland, Pontiac, Michigan, and || Department of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, Michigan
* Address correspondence to Kyle Anderson, MD, 27207 Lahser Road, Suite 200-B, Southfield, MI 48034 (e-mail: Kanderson_md{at}hotmail.com).
Background: Although arthroscopic repairs of the rotator cuff are becoming increasingly popular, security of fixation remains a concern. Two-row repairs have been described, but clinical outcome reports have primarily involved open techniques.
Hypothesis: An arthroscopic repair technique that uses 2 rows of fixation produces satisfactory outcome and structural integrity by ultrasonography.
Study Design: Case series; Level of evidence, 4.
Methods: Forty-eight patients (52 shoulders) with a full-thickness, but fully reducible, rotator cuff tear who met the inclusion criteria were treated with an arthroscopic rotator cuff repair using 2 rows of suture anchors. The mean tear size was 2.47 cm (range, 1–4 cm). Patients were evaluated by subjective functional assessment (L’Insalata Shoulder Rating Questionnaire), clinical examination, including measured strength testing, and ultrasonography.
Results: At a mean follow-up of 30 months (minimum of 2 years), functional scores improved from a mean of 42 preoperatively to 93 postoperatively (P < .001). Active range of motion was increased in all measured planes (P < .001). Strength was also increased in elevation (P < .001), external rotation (P < .001), and internal rotation (P = .033). Nine of the 52 shoulders (17%) had evidence of retear or persistent defect on postoperative ultrasonography. There were no differences detected in functional scores between those with an intact repair and those with a defect, but those with an intact repair were stronger in elevation (P = .006) and external rotation (P = .001).
Conclusion: An arthroscopic 2-row rotator cuff repair produces excellent functional outcome and repair integrity comparable with previously reported open repairs. Presence of a defect after repair did not appear to affect patient-reported function and return to preinjury activity but did affect measured strength.
Key Words: shoulder • rotator cuff • repair • 2 row • ultrasound
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