Park Jin-Young, Lhee Sang-Hoon, Choi Jin-Hyung, Park Hong-Keun, Yu Je-Wook, Seo Joong-Bae
Shoulder, Elbow and Sports Service, Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea.
Am J Sports Med. 2008 Jul;36(7):1310-6. doi: 10.1177/0363546508315039. Epub 2008 Apr 15.
Although research has demonstrated the superiority of double-row rotator cuff repair over single-row methods from a biological and mechanical point of view, few studies have compared clinical outcome of the 2 methods, and no articles have been published describing the superiority of double-row methods in clinical aspects.
Arthroscopic double-row repair of a rotator cuff tear has superior clinical outcome to single-row repair.
Cohort study; Level of evidence, 2.
The study included 78 patients operated on for full-thickness rotator cuff tears between May 2002 and May 2004. A single-row fixation method was used in the first consecutive 40 patients, and a double-row fixation method was used in the next consecutive 38 patients. The mean age at surgery was 56 years. At 2 years after surgery, final evaluation was done with American Shoulder and Elbow Surgeons and Constant scoring systems and the Shoulder Strength Index. The Shoulder Strength Index is a new evaluation method to estimate relative shoulder strength compared with the unaffected shoulder.
At final follow-up, the average American Shoulder and Elbow Surgeons scores were 91.6 in the single-row group and 93.0 in the double-row group. The Constant score was 76.7 in the single-row group and 80.0 in the double-row group. Functional outcome was improved in both groups after surgery, but there was no significant difference between the 2 groups. When the patients were further divided by size of tear, there was still no difference between the repair techniques in the patients with small to medium (<3 cm) tears. However, in patients with large to massive tears (>3 cm), the American Shoulder and Elbow Surgeons and Constant scores and Shoulder Strength Index were all significantly better in the group that had double-row repair.
Small to medium rotator cuff tears should be repaired with the single-row method, and large to massive tears should be repaired with the double-row method.
尽管从生物学和力学角度的研究已证明双排肩袖修复术优于单排修复术，但很少有研究比较这两种方法的临床疗效，且尚无文章发表论述双排修复术在临床方面的优势。
关节镜下双排修复肩袖撕裂的临床疗效优于单排修复。
队列研究；证据等级，2级。
本研究纳入了2002年5月至2004年5月间因全层肩袖撕裂接受手术的78例患者。前连续40例患者采用单排固定法，后连续38例患者采用双排固定法。手术时的平均年龄为56岁。术后2年，采用美国肩肘外科医师协会（American Shoulder and Elbow Surgeons）评分系统、Constant评分系统及肩部力量指数（Shoulder Strength Index）进行最终评估。肩部力量指数是一种新的评估方法，用于估计与未受影响肩部相比的相对肩部力量。
在最终随访时，单排组美国肩肘外科医师协会评分平均为91.6分，双排组为93.0分。单排组Constant评分为76.7分，双排组为80.0分。两组术后功能均有改善，但两组间无显著差异。当根据撕裂大小进一步划分患者时，小至中等（<3 cm）撕裂的患者中，两种修复技术仍无差异。然而，在大至巨大（>3 cm）撕裂的患者中，双排修复组的美国肩肘外科医师协会评分、Constant评分及肩部力量指数均显著更好。
小至中等大小的肩袖撕裂应采用单排法修复，大至巨大撕裂应采用双排法修复。
