Our Summary

This study analyzed previous scientific research comparing two surgical techniques for repairing the rotator cuff, a group of muscles and tendons in the shoulder. The methods compared were single-row (SR) and double-row (DR) repairs. The researchers examined patient outcomes from these surgeries, including various measures of shoulder function and the rates at which the surgery had to be redone due to a tear.

Seven high-quality studies were included in this analysis. The results showed that patients who had the DR repair had a slightly better shoulder function, but the difference was not statistically significant. The only measure of shoulder function where DR repair was significantly better than SR was the UCLA score. In terms of repeat surgeries, the rate of full-thickness tears was similar for both types of repair. However, the rate of partial-thickness tears that required repeat surgery was significantly lower in the DR repair group.

In conclusion, this analysis of short- and mid-term studies found that the DR repair method was associated with slightly better shoulder function and a lower rate of partial-thickness tears requiring repeat surgery. However, the only significantly better result for DR repair was in the UCLA score. This contrasts with long-term studies, which found that DR repair was superior in both function and structural integrity of the shoulder.

FAQs

  1. What are the two surgical techniques for repairing the rotator cuff that were compared in the study?
  2. What were the main findings of the study comparing single-row (SR) and double-row (DR) repairs of the rotator cuff?
  3. Is the double-row repair method superior to the single-row method in the long term based on the studies analyzed?

Doctor’s Tip

A doctor may advise a patient undergoing rotator cuff repair to consider double-row repair as it may lead to better shoulder function and a lower rate of partial-thickness tears requiring repeat surgery. However, the difference in outcomes between single-row and double-row repairs may not be significant in the short-term, so it is important to weigh the potential benefits and risks with your doctor before making a decision. Additionally, following post-operative rehabilitation exercises and instructions is crucial for a successful recovery and optimal outcomes.

Suitable For

Patients who are typically recommended rotator cuff repair are those who have a significant rotator cuff tear that is causing pain, weakness, and limited range of motion in the shoulder. These patients may have tried conservative treatments such as physical therapy and cortisone injections without success. The decision to recommend surgery, and whether to perform a single-row or double-row repair, will depend on factors such as the size and location of the tear, the patient’s age and activity level, and the surgeon’s preference and experience with the different techniques. Ultimately, the goal of rotator cuff repair surgery is to improve shoulder function, reduce pain, and prevent further damage to the shoulder joint.

Timeline

Overall, the timeline for a patient undergoing rotator cuff repair surgery typically involves the following steps:

Before surgery:

  1. Patient experiences shoulder pain, weakness, and limited range of motion.
  2. Patient consults with a healthcare provider who recommends surgery to repair the rotator cuff.
  3. Patient undergoes pre-operative evaluations and tests to assess their overall health and fitness for surgery.
  4. Surgery is scheduled, and the patient receives instructions on how to prepare for the procedure.

After surgery:

  1. Patient undergoes rotator cuff repair surgery, either using the single-row or double-row technique.
  2. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  3. Patient begins a rehabilitation program to regain strength and range of motion in the shoulder.
  4. Patient attends follow-up appointments with their healthcare provider to monitor their progress and adjust their rehabilitation plan as needed.
  5. Patient gradually returns to normal activities and experiences improvements in shoulder function over time.

Overall, the timeline for a patient undergoing rotator cuff repair surgery can vary depending on the individual and the specific surgical technique used. It is important for patients to follow their healthcare provider’s recommendations for post-operative care and rehabilitation to ensure successful outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with rotator cuff repair surgery?
  2. What is the expected recovery time and rehabilitation process after surgery?
  3. How long will it take before I can return to normal activities, such as work or sports?
  4. What type of physical therapy or exercises will I need to do after surgery?
  5. Will I need any additional treatments or follow-up appointments after the surgery?
  6. What is the success rate of the specific surgical technique being recommended (single-row vs. double-row)?
  7. How likely is it that the surgery will need to be redone in the future?
  8. Are there any alternative treatments or non-surgical options that I should consider?
  9. What can I do to help prevent future shoulder injuries or tears after the surgery?
  10. Are there any specific lifestyle changes or modifications that I should make to support the healing process?

Reference

Authors: Sobhy MH, Khater AH, Hassan MR, El Shazly O. Journal: Eur J Orthop Surg Traumatol. 2018 May;28(4):593-605. doi: 10.1007/s00590-018-2145-7. Epub 2018 Feb 13. PMID: 29442181