Three-Year Functional Outcome of Transosseous-Equivalent Double-Row vs Single-Row Repair of Small and Large Rotator Cuff Tears. A Double-Blinded Randomized Controlled Trial

Abstract Background The trial aimed to prospectively compare the functional outcome of patients undergoing arthroscopic rotator cuff repair using Transosseous-Equivalent Double-Row (TEDR) or single-raw (SR) suture anchor techniques at three years postoperatively for both large (over 3cm) and small (under 3cm) tears. Methods Eighty patients with a symptomatic and MRI proven full-thickness RC tear, who had failed conservative management of at least 6 months duration and who had a complete passive range of motion of the affected shoulder were enrolled in the trial. Patients were randomized to TEDR repair (n=40) or SR repair (n=40). Subgroup analysis was conducted for tears 3 cm (TEDR n=23, SR n=21). Primary outcomes included the Oxford Shoulder Score (OSS), the University of California, Los Angeles score (UCLA), and the Constant-Murley Outcome Score (CMS). The secondary outcomes included a 0-100 mm Visual Analogue Scale (VAS) for pain, range of motion (ROM) and EQ-5D. All patients completed a follow-up period of three years. Results There was a significant difference in the mean OSS postoperative score for tears >3cm (p=0.01) and mean improvement from baseline in the TEDR group (p=0.001). For tears >3cm, mean postoperative scores were also significantly higher in the TEDR group for UCLA (p=0.015) and CMS (p=0.001). Post Hoc testing showed that the differences between these groups was statistically significant (p Conclusions TEDR repair showed improved functional outcomes for tears greater than 3cm when compared to SR repair. For tears less than 3cm, no clear benefit was seen with either technique. Level of evidence Level I; Randomized Controlled Trial; Treatment Study