Clinical and Structural Outcomes of Arthroscopic Single-Row Repair in Goutallier Grade II/III Rotator Cuff Tears.
Year: 2026
Type: article
Abstract: Introduction: Rotator cuff tears represent one of the most common causes of shoulder pain and disability in middle-aged and elderly individuals. While double-row repair is considered the biomechanical standard of care in high-income countries and corporate healthcare institutions, single-row repair offers a cost-effective alternative with comparable clinical and functional outcomes, making it especially relevant in resource-constrained environments. Objectives: The primary objective of this study was to evaluate the clinical and functional outcomes of arthroscopic single-row repair in patients with full-thickness supraspinatus and/or infraspinatus tears with Goutallier grade II or III fatty infiltration. In addition, we aimed to objectively assess the structural integrity of the repaired tendon at a minimum interval of 1 year post-operatively using high-resolution ultrasound (HRUS). Materials and Methods: We conducted an ambispective cohort study at Nizam's Institute of Medical Sciences, Hyderabad, analyzing 30 patients who underwent arthroscopic rotator cuff repair using the single-row technique between May 2023 and April 2025. Inclusion criteria comprised patients with symptomatic full-thickness tears and Goutallier grade II or III fatty infiltration on magnetic resonance imaging who underwent surgery following failed conservative management. Exclusion criteria included massive irreparable tears, severe Goutallier grade IV atrophy, concurrent advanced glenohumeral osteoarthritis, or previous shoulder surgeries on the ipsilateral side. Outcome Measures: Pre-operative and post-operative American Shoulder and Elbow Surgeons (ASES) and University of California, Los Angeles (UCLA) scores were evaluated to determine clinical and functional recovery. Tendon structural integrity was assessed using follow-up HRUS. Results: The median follow-up duration was 20 months (interquartile range 16-28.75). The median ASES score improved significantly from 31 to 87.5, and the median UCLA score improved from 8.5 to 31.5 (both P < 0.001). Post-operative HRUS demonstrated an intact repair in 19 patients (63.3%) and a structural re-tear in 11 (36.7%), comprising 8 partial-thickness and 3 complete full-thickness re-tears. Post-operative ASES and UCLA scores did not differ significantly between patients with intact repairs and those with re-tears. Conclusion: Arthroscopic single-row rotator cuff repair achieves marked, durable clinical and functional improvement in patients with Goutallier grade II and III fatty infiltration despite a notable structural re-tear rate. Good functional recovery does not always directly correlate with structural failure.
Source: PubMed
Institution: Nizam's Institute of Medical Sciences
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225592768