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 properties of high-tension double-row versus reduced-tension single-row repair techniques in massive rotator cuff tears.
Methods
Cadaveric biomechanical testing assessed repair footprint restoration, gap formation under cyclic loading, and ultimate load to failure between the two repair methods.
Key Findings
- High-tension double-row repairs restored more of the anatomical footprint but generated increased stress at the tendon-bone interface.
- Reduced-tension single-row repairs demonstrated less gap formation and greater resistance to failure at lower loads.
- The results reveal a trade-off between maximizing anatomical footprint coverage and minimizing biomechanical stress on the repair.
Conclusion
Reduced-tension single-row repair may provide a safer biomechanical profile in massive rotator cuff repairs despite less footprint restoration.
What Does This Mean for Providers?
When managing massive rotator cuff tears, consider the potential benefits of reduced-tension single-row repair to minimize repair site stress and failure risk. Balancing footprint restoration with biomechanical safety is critical to optimizing surgical outcomes.