Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Arthroscopy. 2011 Apr;27(4):453-62. doi: 10.1016/j.arthro.2010.11.059.
The purpose of this study was to compare the clinical outcomes and the retear rates of arthroscopic single-row (SR) and double-row (DR) suture anchor repair in 2- to 4-cm rotator cuff tears.
From 2005 to 2007, 71 patients with a 2- to 4-cm rotator cuff tear (proven by arthroscopy) were prospectively randomized to SR and DR repair groups. Of these patients, 62 (31 in each group) were available for evaluation at final follow-up. Demographic data, clinical scores, mean surgical times, and patient satisfaction were compared. Retear rates and clinical scores were also analyzed for 47 patients who underwent follow-up magnetic resonance imaging.
Comparisons of demographic data, tear size on preoperative magnetic resonance imaging, global fatty degeneration index, and concomitant procedures showed no differences between the SR and DR groups. Preoperative clinical scores were significantly improved postoperatively in both groups. No intergroup differences in pain visual analog scale, American Shoulder and Elbow Surgeons, Constant, or University of California, Los Angeles scores were found at final follow-up. Only mean surgical time was significantly different between the 2 groups. In the SR group, there were 4 full-thickness retears and 11 partial-thickness retears, whereas in the DR group, there were 6 full-thickness retears and 1 partial-thickness retear. However, despite numerical differences, these differences were not statistically different. Statistically, there were no significant differences both in full-thickness retear (P = .999) and retear including partial-thickness tear between the 2 groups (P = .124).
This study indicates that the clinical results and retear rates of DR repair with 1 additional medial suture anchor were not significantly different from those of SR repairs with 2 lateral suture anchors in patients with medium to large rotator cuff tear.
Level I, randomized controlled trial.
本研究旨在比较关节镜下单排（SR）和双排（DR）缝线锚定修复 2-4cm 肩袖撕裂的临床疗效和再撕裂率。
2005 年至 2007 年，前瞻性随机将 71 例 2-4cm 肩袖撕裂（经关节镜证实）患者分为 SR 和 DR 修复组。其中 62 例（每组 31 例）在最终随访时可进行评估。比较两组的人口统计学数据、临床评分、平均手术时间和患者满意度。还对 47 例接受随访磁共振成像的患者进行了再撕裂率和临床评分分析。
两组间的人口统计学数据、术前磁共振成像上的撕裂大小、整体脂肪变性指数和伴随手术无差异。两组患者术后临床评分均显著改善。最终随访时，两组间疼痛视觉模拟评分、美国肩肘外科医生评分、Constant 评分或加利福尼亚大学洛杉矶分校评分均无差异。仅两组间的平均手术时间存在显著差异。SR 组有 4 例全层撕裂和 11 例部分层撕裂，DR 组有 6 例全层撕裂和 1 例部分层撕裂。然而，尽管存在数值差异，但这些差异无统计学意义。在全层撕裂（P=.999）和包括部分层撕裂的再撕裂方面，两组间差异均无统计学意义（P=.124）。
本研究表明，对于中等至大型肩袖撕裂患者，DR 修复中增加 1 个内侧缝线锚钉与 SR 修复中使用 2 个外侧缝线锚钉的临床结果和再撕裂率无显著差异。
I 级，随机对照试验。
