• Double-Row Solutions
• Optimizing Double-Row Repairs
• Double-Row Procedures
• Clinical References

The Advantages of Double-Row Repair

Anatomic reconstruction of the rotator cuff footprint is a key element of the ideal repair. ^5-7 Recent studies have demonstrated that the double-row repair technique consistently provides a larger footprint than the single-row knotted method and that the reconstruction may permit a higher quality of repair. ^8-12

Biomechanically, double-row arthroscopic techniques have been shown to be superior to knotted single row, with:

• 60% greater contact area on greater tuberosity ¹²
• Twice the supraspinatus footprint coverage ¹²
• Twice the rate of complete tendon reattachment ¹³
• Superior initial strength, stiffness, strain, and gap formation ¹⁴

Clinical Evidence

Clinical studies have been less conclusive regarding benefits of double-row repair constructs. Franceschi and Charousset independently found no significant difference in clinical outcomes after two years between single-row and double-row repairs, although Charousset showed that double-row repairs provided improvements in tendon-to-bone reattachment rates.^15,16

More recently, Burks also found no clinical or MRI differences between patients repaired with single-row or double-row technique at 1 year. ¹⁸

A study by Park, however, showed that for large and massive tears (>3cm), double-row repairs have significantly better clinical outcomes. The study concludes that large to massive tears should be repaired with the double-row method. ¹⁷

The data suggest that, for certain populations, double-row arthroscopic repairs may be more appropriate for large to massive tears. ^4,13