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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

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

Review published: 2013.

Bibliographic details: Zhang Q, Ge H, Zhou J, Yuan C, Chen K, Cheng B.  Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. PLOS ONE 2013; 8(7): e68515. [PMC free article: PMC3708899] [PubMed: 23874649]

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.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 23874649

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