A Multicenter Randomized Controlled Trial Comparing Single Row with Double Row Fixation in Arthroscopic Cuff Repair: Long Term Follow-Up

Description

In this presentation, Peter Lapner discusses the long-term results of a multicenter randomized controlled trial comparing single row and double row fixation techniques in arthroscopic rotator cuff repair. He acknowledges the collaboration with the team at the Pan Am Center in Winnipeg and highlights the issue of rotator cuff repair failure, noting that rates can range from 20% to 68%. The aim of the trial was to evaluate whether the addition of a second row in fixation could improve healing rates, mimicking the approach used in open repair, yet the surgical community remains divided on its use due to added time, cost, and complexity.



Lapner outlines the trial's design, patient inclusion criteria, primary outcomes using the Western Ontario Rotator Cuff Index, and secondary outcomes like the ASES and constant score, emphasizing the 10-year follow-up study and the assessment timeline. He mentions the sample size and describes the return rate of patients for long-term follow-up.



The results show that both groups experienced a significant decrease in functional scores over the 10-year period, yet no statistically significant differences were found between the two fixation methods regarding functional outcomes or healing rates. Additionally, a minimal difference was noted in healing rates between the 2-year and 10-year follow-up, with a couple of participants undergoing revision surgery during the study. In conclusion, despite the observed decline in functional scores, the study indicates no clear advantage of double row fixation over single row fixation at long-term follow-up.

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