Arthroscopic Single and Double Row Repair of Isolated and Combined Subscapularis Tears Result in Similar Improvements in Outcomes: A Systematic Review

Limited Biomechanical Evidence Behind Single Row Versus Double Row Repair of Subscapularis Tears: A Systematic Review

“…Overall, single row repair accounted for the most common construct investigated in biomechanical studies of subscapularis repair, which is in line with findings that the majority of clinical studies use single row constructs as well. 21 There were 2 studies that directly compared singlerow to double-row suture anchor repair, although the double-row constructs varied between studies. Dyrna et al 28 focused their repair toward the "leading-edge" by placing a lateral-row anchor superolaterally outside of the native footprint.…”

“…These findings are similar to those in clinical practice, as clinical studies on subscapularis repair tended to use double-row constructs for larger, Lafosse III and IV tears, and single-row constructs for smaller subscapularis tears. 21 Prior systematic reviews of biomechanical evidence for rotator cuff constructs have focused on the posterosuperior rotator cuff, concluding that double-row constructs are biomechanically stronger to single-row fixation. 23,39 Shi et al 39 performed a meta-regression of 40 posterosuperior rotator cuff biomechanical e6 studies and found that the repair material such as number of sutures, suture limbs passed through the tendon, and mattress stitches are stronger predictors of rotator cuff repair strength than the type of construct.…”

“…3,44 The small number of studies found in the current investigation mirror the finding that fewer clinical studies targeting subscapularis repair exist as compared to studies of the posterosuperior rotator cuff. 21,45 Isolated tears make up about 10% to 25% 8,46 of all subscapularis lesions (5% of all rotator cuff repairs) 5,8,10 and are usually associated with a traumatic event, although subscapularis tears occur more often in combination with other rotator cuff tears. The rate of isolated subscapularis re-tear has been reported to range from 5% to 17%.…”

“…[15][16][17][18][19][20] Clinical studies have demonstrated that arthroscopic single-and double-row repair of subscapularis tears results in significant improvements in clinical outcomes. 21 Numerous biomechanical studies have compared the strength of single-row and double-row repairs for supraspinatus and infraspinatus tears, [15][16][17][18][19][20]22 and a systematic review concluded that double-row constructs restored more of the anatomic footprint and had stronger biomechanical properties compared to single-row repairs for posterosuperior rotator cuff tears. 23 However, the anatomical and functional differences between the subscapularis and the posterosuperior rotator cuff necessitate biomechanical studies pertaining directly to the subscapularis to determine the strongest repair construct.…”

A novel high mechanical and excellent hydrophilic electrospun polyurethane‐silk‐bioactive glass nanofiber film for rotator cuff injury repair

“…4 At present, the most commonly used method to treat rotator cuff injury is arthroscopic rotator cuff repair. 5 However, some scholars believed the poor strength of the scar tissue formed by the traditional postoperative tendon-osseointegration surface is an important reason for the failure of the repair owing to the special structure of the rotator cuff, which consists of four parts: tendons, uncalcified fibrocartilage, calcified fibrocartilage and bone tissue. [6][7][8] Traditional surgical methods for rotator cuff repair could not achieve satisfactory results, especially the incidence of rotator cuff tissue non-union and rotator cuff re-tear much high after the repair of large-area rotator cuff injuries.…”