A systematic review of the clinical outcomes of single row versus double row rotator cuff repairs.

Rotator cuff tears are a ubiquitous cause of shoulder pain and disability. Full thickness rotator cuff tears are present in 19-21% of the general population, and their prevalence increases with age. The incidence of this problem is exacerbated by the ever advancing age of our patient population. Thankfully, with advances in arthroscopic rotator cuff repair, this has become a treatable problem with low morbidity, few complications, and good success. Although patients can do well in the face of a persistent or recurrent rotator cuff tear after arthroscopic repair, several studies have documented better subjective and objective results when the rotator cuff tear has been documented to heal. It is for this reason that much emphasis and many resources have been dedicated to improving the success of rotator cuff healing after arthroscopic repair. Several areas have been explored as possible solutions to this complex problem. Proposals have included improving patient factors such as smoking cessation. Improving the local milieu with various growth factors and scaffolds has also been suggested. However, the 1 factor that has probably received the most attention to date is improving the initial fixation strength and recreating the anatomic footprint of the rotator cuff to ameliorate this problem. Traditional open rotator cuff repairs using tranosseous bone tunnels had the advantage of reapproximating the rotator cuff tendon solidly onto the greater tuberosity while