Comparative Outcomes of Single-Row and Double-Row Arthroscopic Rotator Cuff Repair

Background: Arthroscopic rotator cuff repair is widely used for the treatment of symptomatic rotator cuff tears. Single-rowand double-row fixation techniques are commonly employed, but controversy remains regarding whether the additionalfixation provided by double-row repair results in superior clinical and structural outcomes. Aim: The goal of this study wasto compare arthroscopic single- versus double-row rotator cuff repair with a larger sample size. Materials and Methods: Acomparative clinical study was conducted among 150 patients undergoing arthroscopic rotator cuff repair. Patients weredivided into a single-row group (n=88) and a double-row group (n=62). Preoperative demographic and clinicalcharacteristics were recorded. Clinical outcomes were assessed using the Visual Analogue Scale (VAS), Constant score,American Shoulder and Elbow Surgeons (ASES) score, and University of California, Los Angeles (UCLA) score. Range ofmotion, including forward flexion and external rotation, was also assessed. Structural integrity of the repair was evaluated byrecording intact repairs and retears. Outcomes were compared between the two groups using appropriate statistical tests,with p<0.05 considered statistically significant. Results: The demographic and preoperative clinical characteristics werebroadly comparable between the two groups. At final follow-up, the mean VAS score was 1.9 ± 1.4 in the single-row groupand 2.2 ± 0.9 in the double-row group. Mean Constant scores were 82.3 ± 13.6 and 84.2 ± 9.8, while mean ASES scoreswere 86.5 ± 10.1 and 87.1 ± 8.9, respectively. Mean UCLA scores were 30.6 ± 5.8 in the single-row group and 31.4 ± 4.6 inthe double-row group. These functional outcomes did not differ significantly between the groups. The mean time to return todaily activities and sports activities differed significantly between the groups. Regarding structural integrity, 62 patients inthe single-row group and 52 patients in the double-row group had intact repairs, whereas retears occurred in 26 and 10patients, respectively. The difference in repair integrity was statistically significant (p=0.021). Conclusion: Both single-rowand double-row arthroscopic rotator cuff repair resulted in satisfactory clinical and functional outcomes. Double-row repairdemonstrated a significant advantage in structural integrity, with a lower retear rate and a greater proportion of intact repairs.However, this structural advantage was not accompanied by significant differences in the major postoperative functionalscores. Double-row repair may therefore be particularly valuable when maximizing tendon healing and reducing structuralfailure is a priority.