Linked Double-Row Equivalent Arthroscopic Rotator Cuff Repair Leads to Significantly Improved Patient Outcomes

Atsushi Endo, Paul Hoogervorst, Conrad Safranek, Kyle R. Sochacki, Marc R. Safran, Seth L. Sherman, Joseph Donahue

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Background: Biomechanical studies have demonstrated that arthroscopic rotator cuff repair using a linked double-row equivalent construct results in significantly higher load to failure compared with conventional transosseous-equivalent constructs. Purpose: To determine the patient-reported outcomes (PROs), reoperation rates, and complication rates after linked double-row equivalent rotator cuff repair for full-thickness rotator cuff tears. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients who underwent linked double-row equivalent arthroscopic rotator cuff repair with minimum 2-year follow-up were included. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score at final follow-up. Secondary outcomes included the Simple Shoulder Test (SST), shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, visual analog scale (VAS), reoperations, and complications. Clinical relevance was defined by the minimally clinically important difference (MCID). Comparisons on an individual level that exceeded MCID (individual-level scores) were deemed clinically relevant. Comparisons between preoperative and postoperative scores were completed using the Student t test. All P values were reported with significance set at P <.05. Results: A total of 42 shoulders in 41 consecutive patients were included in this study (21 male patients [51.2%]; mean age, 64.5 ± 11.9 years; mean follow-up, 29.7 ± 4.5 months). All patients (100%) completed the minimum 2-year follow-up. The rotator cuff tear measured on average 15.2 ± 8.9 mm in the coronal plane and 14.6 ± 9.8 mm in the sagittal plane. The ASES score improved significantly from 35.5 ± 18.2 preoperatively to 93.4 ± 10.6 postoperatively (P <.001). The QuickDASH (P <.001), SST (P <.001), and VAS (P <.001) scores also significantly improved after surgery. All patients (42/42 shoulders; 100%) achieved clinically relevant improvement (met or exceeded MCID) on ASES and SST scores postoperatively. There were no postoperative complications (0.0%) or reoperations (0.0%) at final follow-up. Conclusion: Arthroscopic repair of full-thickness rotator cuff tears with the linked double-row equivalent construct results in statistically significant and clinically relevant improvements in PRO scores with low complication rates (0.0%) and reoperation rates (0.0%) at short-term follow-up.

Original languageEnglish (US)
JournalOrthopaedic Journal of Sports Medicine
Issue number7
StatePublished - Jul 1 2020

Bibliographical note

Funding Information:
One or more of the authors has declared the following potential conflict of interest or source of funding: M.R.S. has received research support from Smith & Nephew; consulting fees from Anika Therapeutics, Linvatec, Medacta, and Smith & Nephew; speaking fees from Linvatec, Medacta, and Smith & Nephew; and royalties from DJO, Saunders/Mosby-Elsevier, Smith & Nephew, Stryker, and Wolters Kluwer Health–Lippincott Williams & Wilkins; and has stock/stock options in Biomimedica. S.L.S. has received research support from Arthrex, grant support from DJO, educational support from Elite Orthopaedics, hospitality payments from Smith & Nephew, and consulting fees from Arthrex, Ceterix Orthopaedics, ConMed Linvatec, Flexion Therapeutics, GLG Consulting, JRF Ortho, Moximed, Olympus, RTI Surgical, and Vericel. J.D. has received educational support from Arthrex and consulting fees from DePuy; and has stock/stock options in Stabilynx. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Publisher Copyright:
© The Author(s) 2020.


  • arthroscopy
  • linked suture anchors
  • outcomes
  • rotator cuff repair


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