Arthroscopic Rotator Cuff Repair: Single or Double Row?

Abstract

Optimal treatment for rotator cuff tears remains a controversial topic with a wide variation in clinical practice. We aim to summarise the history of rotator cuff tear surgery and its’ evolution based upon biomechanical and clinical research with respect to the options available today. Arthroscopic repair of the rotator cuff tear has become the gold standard intervention in the last 3 decades and a multitude of options now exist. Considerable debate and discussion has centred on the ‘single row’ or ‘double row’ repair techniques. We will consider the relative merits of each technique in terms of their clinical, technical and financial implications. Rotator cuff pathology is an area that encompasses a wide range of clinical scenarios; hence it is not possible to be entirely prescriptive regarding a technique across the board. It is however important to be familiar with the merits, pitfalls and evidence relative to each in order to inform clinical practice. Furthermore, we believe a good shoulder arthroscopist should be proficient in both single and double row techniques and have an insight into the advantages and disadvantages of each in their own hands.