Is there a difference in clinical outcomes and repair integrity between arthroscopic single-row versus transosseous (anchorless) fixation? A retrospective comparative study

BACKGROUND: Few studies have investigated clinical and structural outcomes after transosseous (TO) repair. The purpose of this study was to compare structural andclinical outcomes of rotator cuff tear, repaired arthroscopically, with a single row (SR) or transossoeus (TO) anchorless technique.METHODS: 96 patients who underwent an arthroscopic repair for superior orposterosuperior rotator cuff tear using TO (n:54) or a SR (n:42) wereretrospectively enrolled in this study after evaluation of clinical and surgical notes. Functional evaluation was performed with the adjusted Constant score, and American Shoulder and Elbow Surgeons (ASES) score. Postoperative cuff integritywas determined through MRI study.RESULTS: Patients were recalled after a minimum follow-up of two years. All thepatients were available for the study. In the SR group the Constant rating systemshowed a significant improvement from a preoperative average rating of 44.8 to anaverage of 85.7. In the group of TO repair the Constant rating system showed asignificant improvement from a preoperative average of 46.1 to an average of 87.6postoperatively. According to ASES index scores, the average total score improvedfrom 42.8 to 92.0 in the anchor group and from 40.4 to 94.6 in the TO group.There was no statistical difference between the two groups about clinicaloutcomes. Postoperative MRI revealed no differences in term of complete re-tears between the two techniques. In the SR group at MRI we observe significant morecases of rotator cuff with a Sugaya type III healing.CONCLUSIONS: Arthroscopic rotator cuff repair yielded successful clinicaloutcomes using SR and TO technique. However using the TO technique we saw lesstype 3 Sugaya readings on MRI suggesting a possible benefit with TO repair.LEVEL OF EVIDENCE II: Retrospective study.