High-Tension Double-Row Footprint Repair Compared With Reduced-Tension Single-Row Repair for Massive Rotator Cuff Tears
Authors
Domb BG, Glousman RE, Brooks A, Hansen M, Lee TQ, ElAttrache NS
DOI: 10.2106/JBJS.H.00650
Purpose
To compare the biomechanical integrity of high-tension double-row rotator cuff repair with a reduced-tension single-row technique in massive tears.
Methods
The study involved cadaveric biomechanical testing of rotator cuff repairs using either a high-tension double-row or a reduced-tension single-row method. Repair footprint, gap formation, and load to failure were measured.
Key Findings
- High-tension double-row repairs restored more of the original footprint but had higher stress at the tendon-bone interface.
- Reduced-tension single-row repairs had lower risk of gapping and were less likely to fail at lower loads.
- The study highlighted a trade-off between anatomical restoration and biomechanical stress tolerance.
Conclusion
Reduced-tension single-row repair may be biomechanically safer in massive rotator cuff tears, despite restoring less of the anatomical footprint compared to high-tension double-row repair.
What This Means for Patients
For patients with large rotator cuff tears, a less aggressive repair technique may lower the risk of re-tear and improve post-surgical healing, even if it doesn’t fully restore tendon coverage.